# Rational healthcare debate - politics free zone **URL:** \ **Category:** Great Debates\ **Created:** [September 11, 2009, 3:14pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690 "2009-09-11T15:14:58Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![The\_Controvert](https://avatars.discourse-cdn.com/v4/letter/t/dec6dc/32.png) [@The\_Controvert](https://boards.straightdope.com/u/The_Controvert)\ **Post date:** [September 14, 2009, 3:25pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/61 "2009-09-14T15:25:53Z")
I already explained several times, I’m one of the people who doesn’t pay anything for health care. So, forcing UHC on me is more expensive to me. I’m one of the people who will be subsidizing everyone else. Does that make sense? I’m okay with rationing health care, or having a tiered system where poor people pay less. But they should receive a lower tier level of care. If UHC cannot deny coverage and if it cannot use less expensive alternatives because the patient will always demand the best, then UHC won’t work. ---
**Author:** ![BrainGlutton](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@BrainGlutton](https://boards.straightdope.com/u/BrainGlutton)\ **Post date:** [September 14, 2009, 3:37pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/62 "2009-09-14T15:37:49Z")
> [@Dioptre](#): > > Most healthcare debates degenerate into people accusing one system or another of having properties (like rationing) that are true for all systems, or attacking policies based on success/failure of systems that don’t implement the policy in a pure form. > > So here are the questions: > > All healthcare systems need a source of money. Ultimately, this comes from the people. What is the best way to source this - private insurance, public insurance, direct government spending from tax, vouchers, others? > > All healthcare systems need a system of rationing available care. What is the best basis for rationing? > > All healthcare systems need a reward system for improvements in medical care (new drugs, treatments etc). What is the best way to fund this? > > All healthcare systems need to decide whether people who can’t pay get covered, and whether paying extra can buy better healthcare. What should be allowed? > > Private insurance has an answer to the first three, but I would argue that their answer necessarily implies that some people don’t get covered, and others buy better healthcare, with side effects that it is possible to pay and still NOT get adequate healthcare. Thus, if you believe in a right to health, the question is how to fairly and effectively make a hybrid government / private system. > > Solely government systems need an added mechanism for encouraging private participation in both the research and provision marketplace - this isn’t an automatic necessity, but it seems to be a practical one. > > Any thoughts? You can’t possibly believe any of those are apolitical questions. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 3:58pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/63 "2009-09-14T15:58:02Z")
> [@The\_Controvert](#): > > I already explained several times, I’m one of the people who doesn’t pay anything for health care. So, forcing UHC on me is more expensive to me. I’m one of the people who will be subsidizing everyone else. Does that make sense? > > I’m okay with rationing health care, or having a tiered system where poor people pay less. But they should receive a lower tier level of care. > > If UHC cannot deny coverage and if it cannot use less expensive alternatives because the patient will always demand the best, then UHC won’t work. Are you colossally wealthy? Imagine you slip and fall and hit your head (or get whacked in the head accidentally by a friend or whatever). You are rushed to the hospital and require brain surgery (and do not think this is not possible…actress Natasha Richardson took a seemingly minor blow to the head and even thought she was fine till she dropped dead several hours later). Brain surgery and the attendant hospital stay can easily hit $200,000+ (can go waaaay higher depending on many things). Can you just write a check for all that on the spot? If you can’t then you are making me pay for your surgery because apparently you are uninsured (if you are insured and someone else is picking up 100% of the tab then nothing would change for you under UHC). If you can write a check for that then count yourself lucky and only one of a very tiny minority who could do so. ---
**Author:** ![The\_Controvert](https://avatars.discourse-cdn.com/v4/letter/t/dec6dc/32.png) [@The\_Controvert](https://boards.straightdope.com/u/The_Controvert)\ **Post date:** [September 14, 2009, 5:11pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/64 "2009-09-14T17:11:01Z")
Yes, I will pay for any and all medical expenses I personally incur. I don’t want to pay for any and all medical expenses you incur. I don’t know how much clearer I can make that. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 5:33pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/65 "2009-09-14T17:33:46Z")
> [@The\_Controvert](#): > > Yes, I will pay for any and all medical expenses I personally incur. I don’t want to pay for any and all medical expenses you incur. I don’t know how much clearer I can make that. You already pay for other people’s medical expenses right now. UHC will lower that cost to you. Please explain the mechanism to determine who is able to pay as they are wheeled unconscious into the Emergency Room. Tell me what you do with those deemed unable to pay. Also tell me about how you view a country when the front of hospitals are littered with bleeding, diseased and dying people who the hospital literally kicked to the curb as soon as it was determined they had no ability to pay (and realize that will include some [5.5 million children](http://www.census.gov/hhes/www/hlthins/liuc07.html)). ---
**Author:** ![The\_Controvert](https://avatars.discourse-cdn.com/v4/letter/t/dec6dc/32.png) [@The\_Controvert](https://boards.straightdope.com/u/The_Controvert)\ **Post date:** [September 14, 2009, 6:03pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/66 "2009-09-14T18:03:12Z")
> [@Whack-a-Mole](#): > > You already pay for other people’s medical expenses right now. UHC will lower that cost to you. I don’t go to hospitals and I’m all for UHC if it doesn’t raise costs to me. I paid a grand total of $60 in property taxes last year to the county hospital. Are you saying UHC will lower my cost? If we can guarantee it will never cost me more than $60 per year, then I’m all for it. Please give a detailed explanation of how your UHC plan can pay everyone’s medical expenses with only this money and no additional taxes or deficit spending. As for the unfortunate poor, there’s plenty of heartbreaking stories if you look hard enough. Why stop at medical care? If it only costs me $60, I’ll gladly give another $60 to end all human suffering. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 6:12pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/67 "2009-09-14T18:12:00Z")
> [@The\_Controvert](#): > > I paid a grand total of $60 in property taxes last year to the county hospital. Are you saying UHC will lower my cost? If we can guarantee it will never cost me more than $60 per year, then I’m all for it. Please give a detailed explanation of how your UHC plan can pay everyone’s medical expenses with only this money and no additional taxes or deficit spending. Sure…(bolding mine) > [@](#): > > The U.S. wastes more on health care bureaucracy than it would cost to provide health care to all of the uninsured. Administrative expenses will consume at least $399.4 billion out of total health expenditures of $1,660.5 billion in 2003. Streamlining administrative overhead to Canadian levels would save approximately $286.0 billion in 2003, $6,940 for each of the 41.2 million Americans who were uninsured as of 2001. **This is substantially more than would be needed to provide full insurance coverage.** > > These results are derived from detailed data on administrative costs in the U.S. and Canada in 1999 which appears in tomorrow’s New England Journal of Medicine. This report updates the New England Journal estimates of nationwide administrative spending and potential savings to 2003. The complex and fragmented payment structure of the U.S. health care system increases administrative overhead in the U.S. relative to Canada, where a single-payer national health insurance program has existed since 1971. > > SOURCE: [http://www.medicalnewstoday.com/articles/8800.php](http://www.medicalnewstoday.com/articles/8800.php) Note “substantially more”. So, UHC is paid for with some left over. Costs go down so it will cost less to run your county hospital and (if the government actually lowered the taxes…likely they’d just keep it where it is) you’d pay less. At the least you’d pay no more. ETA: Add in other benefits. Some 60% or more of bankruptcies are due to medical costs (and most of those are to working people with health insurance). No more bankruptcies means more money in company coffers which means higher profits and/or lower costs for goods and services. ---
**Author:** ![The\_Controvert](https://avatars.discourse-cdn.com/v4/letter/t/dec6dc/32.png) [@The\_Controvert](https://boards.straightdope.com/u/The_Controvert)\ **Post date:** [September 14, 2009, 6:53pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/68 "2009-09-14T18:53:57Z")
> [@Whack-a-Mole](#): > > At the least you’d pay no more. This sounds wonderful. You seem fairly confident, would you care to put your money where your mouth is? My total outlay is $60. In the future, can I count on you to personally reimburse me for any future UHC expenses levied on me above $60? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [September 14, 2009, 6:55pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/69 "2009-09-14T18:55:48Z")
> [@Whack-a-Mole](#): > > Sure…(bolding mine) > > Note “substantially more”. So, UHC is paid for with some left over. Costs go down so it will cost less to run your county hospital and (if the government actually lowered the taxes…likely they’d just keep it where it is) you’d pay less. At the least you’d pay no more. So was the CBO lying when it said that Obamacare would cost half a trillion now, and another trillion over ten years? But since UHC is free, then any tax increases can be removed from the final bill, and all expenses covered with administrative savings. As soon as the Democrats and Obama come up with such a bill, I would be glad to support it. > [@](#): > > ETA: Add in other benefits. Some 60% or more of bankruptcies are due to medical costs (and most of those are to working people with health insurance). No more bankruptcies means more money in company coffers which means higher profits and/or lower costs for goods and services. So nobody will pay for the care of folks who would otherwise go bankrupt? Or is this the Magic Tax Fairy who comes up with invisible money again? That is to say, you won’t be reducing costs even a tiny bit - just sending the bill to a different place. Regards, Shodan ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 7:01pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/70 "2009-09-14T19:01:09Z")
> [@The\_Controvert](#): > > This sounds wonderful. You seem fairly confident, would you care to put your money where your mouth is? > > My total outlay is $60. In the future, can I count on you to personally reimburse me for any future UHC expenses levied on me above $60? Will you send me all the money you save if it does save you money? Include improved profits earned by stocks when company’s overhead costs go down and their stocks perform better or they can invest more into improvements and so on. Basically make it a neutral proposition for you. You have no downside or upside. And I note yet again you bring absolutely zero facts or evidence to the discussion but seek to use smoke and mirror rhetoric. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 7:06pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/71 "2009-09-14T19:06:45Z")
> [@Shodan](#): > > So was the CBO lying when it said that Obamacare would cost half a trillion now, and another trillion over ten years? Nope. The difference is the bit I quoted assumes we would get efficiencies akin to what Canada enjoys. Canada has a single-payer system. The US is not proposing a single payer system. Point is such savings ARE there and could be achieved. Just everyone screams Socialism so we are not going to see that efficiency. > [@](#): > > So nobody will pay for the care of folks who would otherwise go bankrupt? Or is this the Magic Tax Fairy who comes up with invisible money again? > > That is to say, you won’t be reducing costs even a tiny bit - just sending the bill to a different place. Not sure what you are asking here. ---
**Author:** ![The\_Controvert](https://avatars.discourse-cdn.com/v4/letter/t/dec6dc/32.png) [@The\_Controvert](https://boards.straightdope.com/u/The_Controvert)\ **Post date:** [September 14, 2009, 7:07pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/72 "2009-09-14T19:07:25Z")
> [@Whack-a-Mole](#): > > Will you send me all the money you save if it does save you money? Include improved profits earned by stocks when company’s overhead costs go down and their stocks perform better or they can invest more into improvements and so on. > > Basically make it a neutral proposition for you. You have no downside or upside. > > And I note yet again you bring absolutely zero facts or evidence to the discussion but seek to use smoke and mirror rhetoric. Yes, gladly. If my property tax payment to the county hospital goes down, I’ll send you the difference, up to $60 per year. I don’t know how you’d calculate these improved profits, but I don’t own any stocks so that’s going to be $0. Shall I draw up a contract and send it over to you to sign? p.s. I linked to facts earlier in this thread. Do you need me to point them out for you, or do you have a bad understanding of what “zero facts” means? ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [September 14, 2009, 7:35pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/73 "2009-09-14T19:35:58Z")
> [@Whack-a-Mole](#): > > Nope. > > The difference is the bit I quoted assumes we would get efficiencies akin to what Canada enjoys. Canada has a single-payer system. The US is not proposing a single payer system. Point is such savings ARE there and could be achieved. Just everyone screams Socialism so we are not going to see that efficiency. Oh. So when you told **The Controvert** that it \*\*wouldn’t \*\*cost him any more money, you meant that it **would**. That’s too bad. I would have hoped that someone as upset as you over “smoke and mirrors rhetoric” would be a little more careful. Regards, Shodan ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 7:40pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/74 "2009-09-14T19:40:13Z")
> [@The\_Controvert](#): > > Yes, gladly. If my property tax payment to the county hospital goes down, I’ll send you the difference, up to $60 per year. I don’t know how you’d calculate these improved profits, but I don’t own any stocks so that’s going to be $0. Shall I draw up a contract and send it over to you to sign? > > p.s. I linked to facts earlier in this thread. Do you need me to point them out for you, or do you have a bad understanding of what “zero facts” means? I saw you provide one link…to something that had already been debunked. And if the whole economy improves seems to me you would benefit. How you would determine what amount benefited you due to health care reform I don’t know. Presumably some economist report that determines some percentage. And till I see the UHC bill that gets passed (if it gets passed) I cannot say anything about whether it will work or not. Quite possible Congress will bumble it. The point however is that is is possible to save a great deal of money via UHC done right. Every industrialized nation in the world offers UHC, all of them cost far less than health care in the US and all of them provide for better overall health outcomes for its citizens. How many more examples do you need? Our system is provably a mess. It is self evident. Other country’s UHC systems are provably less expensive. Also self evident. Not sure how you or others assume if we cut health care costs in half in the US (which would still leave us as the most expensive or nearly so) it is going to cost you more money to live than it did previously. What’s not to like? ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [September 14, 2009, 7:43pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/75 "2009-09-14T19:43:17Z")
> [@Shodan](#): > > Oh. So when you told **The Controvert** that it \*\*wouldn’t \*\*cost him any more money, you meant that it **would**. > > That’s too bad. I would have hoped that someone as upset as you over “smoke and mirrors rhetoric” would be a little more careful. We are talking about whether UHC can save us money. It CAN save us money. The proof is in every industrialized nation in the world with UHC spending half or less than we do for better health care than we get overall. Canada is an illustrative example. Not pie-in-the-sky maybe we think kinda there might be a saving there. A whole country is running it and has those savings. If (note “if”) we moved to a single payer system why would we suppose things would get more expensive? Try to keep up. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 15, 2009, 5:36pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/76 "2009-09-15T17:36:10Z")
> [@The\_Controvert](#): > > Doctors from Taiwan are disallowed from practicing in the United States. Would you change the system to allow them to practice here? Would you be okay with a Taiwanese doctor operating on you and your loved ones? I imagine this is largely due to the language barrier & differences in hospital cultures, not because Taiwan’s doctors are bad doctors. And US policy on allowing Taiwanese to practice is almost certainly not because Taiwan went to socialized medicine. I don’t think they had to start giving licenses to the unqualified just to meet demand. But in the USA, unqualified doctors do practice. Not only are there the frauds with fake M.D.'s, there are chiropractors who try to prescribe medicine (which is beyond their training), there are herb-sellers who don’t know what they’re selling & believe everything in the advertising brochures, and there are the iridologists, the faith healers, the homeopaths, & other quacks. But hey, they’re sometimes cheaper than allopathic medicine, so they get customers! We need to invest in training more actual physicians & nurses, & subsidize their tuition. But the salutary effects of that will be felt five years after we start. In the interim, trimming health insurance may relieve some pain. We also may need more competition in medical labs. I would like to see some grants in that direction. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 15, 2009, 5:38pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/77 "2009-09-15T17:38:54Z")
> [@The\_Controvert](#): > > Ok, then I agree with this solution. Allow any doctor certified from anywhere in the world to work in the US for the UHC program and I’ll go along with the plan. We can pay them a lot less since they didn’t have to pay for expensive US medical schools, and there’s a huge pool of people to draw from. So, I agree this would solve the health care affordability problem. > > Everybody happy now? I hear South Africa is really mad at Canada for poaching their medical schools. Since Canada is richer & South Africa actually needs those doctors. We need to invest in medical education, not shove it off on other, poorer countries. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 15, 2009, 5:41pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/78 "2009-09-15T17:41:52Z")
> [@cosmosdan](#): > > So, while people are claiming that Obama care will force small businesses to close the current system is already working on it. Wait, what? Who’s been saying that? One of the biggest arguments for single payer is that it helps small business, the self-employed, & entrepreneurs! If the present bill doesn’t do that, then throw it out & just make Medicare opt-in! ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [September 15, 2009, 5:43pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/79 "2009-09-15T17:43:47Z")
> [@foolsguinea](#): > > I hear South Africa is really mad at Canada for poaching their medical schools. Since Canada is richer & South Africa actually needs those doctors. > > We need to invest in medical education, not shove it off on other, poorer countries. The UK has done the same in places like the Philliphines - on a grand scale. I don’t like the policy but at least a chunk of the money they earn goes back to the family at home. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 15, 2009, 5:49pm UTC](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690/80 "2009-09-15T17:49:20Z")
> [@The\_Controvert](#): > > Yes, gladly. If my property tax payment to the county hospital goes down, I’ll send you the difference, up to $60 per year. Controvert, do you pay payroll tax or income tax? If so, you’re paying a lot more than that $60, just for Medicare. So knock off the bullshit. [Previous page](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690.md?page=3) [Next page](https://boards.straightdope.com/t/rational-healthcare-debate-politics-free-zone/509690.md?page=5)