There aren’t any countries that reduced their healthcare costs overall over time by switching to UHC. That’s my point.
You’re welcome.
Regards,
Shodan
Your point is stupid, because it’s unprovable as asked. And I’m certain you know that.
If someone points to a country that adopted UHC decades ago, you’ll just point to higher healthcare spending today versus decades ago as proof that you’re “right” (for the loosest possible definition of right). You will of course ignore the growing population, to say nothing of the inflation rate for medical services.
Plus, it isn’t like countries are changing their healthcare systems very often, so there’s an incredibly narrow universe to even look at.
But the facts are that since 1970, healthcare spending as a percentage of GDP has tripled. Countries with universal coverage have much less growth. Link. We’re talking many trillions of cost avoidance in UHC countries compared to the US.
But of course, all of those countries are wrong for whatever reason to be invented. It literally makes no sense that you say you want lower healthcare costs, yet reject the most obvious and proven way to obtain those savings.
Medicare and Medicaid are government run programs so they provide the best evidence as to what government run programs will be like. What savings could come from doubling the size of the current programs that cannot be achieved currently?
The comparisons to other countries is useless. No candidate is advocating paying every healthcare worker in another country to move to the US and keep the lower salary they are currently being paid.
Why doesn’t every country in Europe switch to the Greek health system? It would be much cheaper, they could either cut taxes drastically or fund massive new spending. The reason is that countries can not take on the systems of other countries. The US can not take on another countries system.
In order to pay doctors and nurses what other countries do the government would have to cut their pay drastically. We have evidence that this is not possible with the Medicare doc fix which US government passed a small adjustment to doctor’s pay, then spent 15 years postponing it and then repealing it.
Where are the savings? Can you point to one country that switched to UHC and then drastically spent less on health care? This has never happened. The reason that other countries spend less on health care is that 40-50 years ago their spending rate went up less than the US rate and stayed that way until about 30 years ago when they increase in rates became almost the same but meant that the US was increasing faster because of a higher base rate.
If the US adopted a UHC the best case scenario is that instead of growing at 3.6% a year the US healthcare spending would grown at 3.1%, while doubling the taxes that most people pay. If you account for the deadweight loss of taxation the US would break even in 50 years or so.
What do you mean where are the savings? If you have a home loan at 8% interest, and you refinance to a loan with a 4% rate, are you going to assert that you will save no money?
What are the obvious and proven ways that other countries have cut health care costs?
What are the countries that have cut their health care costs, the way a person cuts his loan payments by refinancing?
My point isn’t at all stupid. I have no idea if you know that or not.
“Unprovable” is different from “irrefutable”. I don’t know if you know that either.
The US spends too much on healthcare. In order to spend less on healthcare, we have to cut spending on healthcare. It is alleged that we can learn from other countries. OK - what other countries have cut spending on healthcare?
Regards,
Shodan
Okay, hospital benefits are a wholly different program within Medicare. I have no experience with that program, but I have heard that reimbursement is too low.
~Max
To be clear, the part where doctors lose money on Medicare, that has only been cited for inpatient services (in the hospital).
~Max
Please look at the link I directed you to earlier, in which the growth in healthcare costs is substantially less in other countries than for the United States.
If currently projected healthcare spending is x over the next 30 years, and reform means that we will instead spend, say, 80% of x, due to slower growth in costs, you may quibble with whether that’s a cut or not. How about we call it “cost avoidance?”
We can surely agree that it is simply common sense to refinance one’s debt at lower interest rates in order to reduce the growth of a debt over time. Why shouldn’t the same principle be applied to healthcare spending?
And if you think your point is irrefutable, let’s see your examples of industrialized countries moving from non-UHC to UHC systems and how much their costs increased. Thanks in advance!
[QUOTE=
wolfpup]
In short, referring to single-payer (or often any form of UHC) as “socialist” is an old conservative scare tactic that goes back decades, whereas referring to it as a “free market” reflects a fundamental truth about how the model basically works, even if there are exceptions and many screwed-up policies.
[/QUOTE]
Cool, should be easy for you to prove then. Show me some evidence that the health care system in the us is modeled on some sort of free market. Give examples. You won’t be able too, because it isn’t. Hell, you are going to run into issues just proving the vast majority of the US healthcare system is ‘private’, because it’s going to be harder to nail that down than you think, since leaving aside the 30-40% that is direct government (Medicare/Medicaid) you also have a host of government subsidies.
What you REALLY mean is that the US system isn’t fully public. But calling it a ‘free market’ is simply wrong, no matter how you want to twist that term.
Instead of giving cites for shit I didn’t ask about nor even mention, feel free to give cites that are relevant. I don’t prefer your inaccurate ‘modeled on basic free-market principles’ because IT’S FUCKING WRONG. Or, show me some aspect of the current private healthcare system in the US that has ANY ‘free market’ ‘principles’. Give me THAT cite, as that’s what I’m asking, not bullshit about Reagan or some stuff about the percentage of folks not covered, which has zero to do with anything I said or implied. Just to be clear, I am not arguing that the current system isn’t broken. I’m not arguing that a single payer system might be better…or worse…or the same. I’m pointing out that single payer systems aren’t socialism, nor is the current US system ‘free market’. It’s more like crony capitalism of the old school variety, with a heavy dose of government intervention that stifles and silos markets and basically allows for near regional monopolies.
But, hell, if you think you have some evidence for any sort of free market principles in our current system, feel free to demonstrate them. Not even a cite required, walk me through something in the private part of the US healthcare system that seems ‘free market’ like to you…because, frankly, if you DO see something, your definition of what is or isn’t a ‘free market’ is radically different to my own. I have the same problem with folks who think they know what ‘socialism’ is, so won’t be the first time…
I can’t find specific information on how per-capita health care costs changed in Ontario (where UHC was introduced in 1968) or in Canada in general, but it was so long ago and the changes probably so gradual that I’m sure all kinds of arguments would be brought that it isn’t relevant. But the following charts should be instructive:
There are good reasons that the US is such an incredible outlier in having much higher costs than anywhere else in the world by such a wide margin, and those reasons inevitably boil down to the unsuitability of private insurance for medically necessary procedures, unless such entities are very tightly regulated… In the US, they absolutely are not regulated in any such way when compared to other countries, or countries like Canada where such insurers don’t exist at all (except to offer supplemental insurance which for most of us is just a frill or entirely unnecessary). “Very tightly regulated” effectively means that for medically necessary procedures, health insurers become nothing more than payment agents for the government.
BTW, the charts not only show US health care costs as a huge outlier, they also show them rising much more rapidly than in other countries.
Canada is a very good basis for comparison because the economy, culture, cost of living, and other factors are so similar to those of the US, yet under single-payer, per-capita health expenditures are about half of what they are in the US. Think about it. Half as much! Yet health care is universal, medical outcomes are similar and in some cases better, and life expectancy and comfort and security in old age far superior. If that’s not convincing, then I think those still unconvinced are so deeply mired in a free-market ideological rut that nothing will ever convince them.
Top health insurers and their New York Stock Exchange trading codes:
UnitedHealth Group - UNH
Anthem - ANTM
Humana - HUM
Centene - CNC
WellCare - WCG
To whom do you think these companies have a primary and fiduciary responsibility? The NYSE and stock investing is the very definition of a capitalist free market.
Top health insurers in Canada:
The provincial governments, in collaboration with the federal government.
So, um, your big example of how healthcare in the US is a ‘free market’ is that the companies are publicly traded…and that it costs a lot? Seriously? I’m asking for examples of how healthcare markets are free in any way, and you come back with ‘well, they are publicly traded’ and some stuff about how the US healthcare costs more than Canada?? :smack:
Sorry, but publicly traded companies is NOT the ‘very definition of a capitalist free market’. Here, I’ll help…this is a definition of a free market: ‘an economic system in which prices are determined by unrestricted competition between privately owned businesses.’ Now, using that definition, instead of the one you made up, can you show me examples of any of those companies acting in a free market in the US healthcare arena? How about ONE example?
(I can actually think of one, actually, so I’ll throw you a bone…lasik surgery is an example of a free market, sort of, in the US healthcare system.)
The individual health exchanges had a sort of market-vibe to them. We do have regulations of course, so the current model isn’t technically “unrestricted”.
~Max
Do you think that Standard Oil was an example of a ‘free market’? It was publicly traded, after all. The fact that companies are or aren’t publicly traded is not an indication of a ‘free market’, one way or the other. I can give plenty of examples of publicly traded companies that aren’t anything like a free market, both historically and today.
The reason US healthcare isn’t a free market is because of how those companies operate in regional markets, the fact that they are often granted almost exclusive access to those local markets without any sort of competition except perhaps by other regional providers who ALSO have the same access (granted by local, state or federal…or often all of those…entities). There are other reasons why they aren’t examples of a ‘free market’, unless your definition is ‘well, they are traded on the NYSE’, but those are the key ones.
Like I said, there are some examples of sort of quasi-free market forces in healthcare in the US. Like the eye surgery example. Ironically, this has had the effect of driving down costs and increasing quality. This isn’t to say that free markets would or could be great at healthcare…I don’t think they would be. Which is WHY WE DON’T HAVE A FREE MARKET HEALTHCARE SYSTEM. It’s more like an old school crony capitalist system…ironically, again, like the Standard Oil example I asked you about earlier.
I’m not going to get into a silly pointless pissing match over exactly what a “free market” is, and whether it’s still a free market if there is any kind of regulation, which there always is. All real-world capitalist systems are regulated capitalism. What I said in post #137 was “referring to the present health care system as ‘free market’ is just a short-hand way of saying that a major part of health care coverage for medically necessary procedures in the US is provided by private for-profit corporations, as compared, say, with zero in Canada, and that most health care providers are for-profit individuals or enterprises.” This is certainly more true than referring to single-payer as a path to socialism, communism, or totalitarianism, all of which are statements that conservatives have made.
I have no problem with private for-profit health care providers, but the former – private for-profit health care insurance – is directly and indirectly the root cause of most of America’s health care woes – and that is my point. Health insurers are businesses, most of them large and publicly traded by investors who want to see them make money; they compete for customers; they work to maximize profits by offering the least possible coverage for the highest possible prices and then denying coverage wherever possible. They offer no added-value whatsoever and huge disadvantages over systems like single-payer or highly regulated multi-payer UHC. There is at least one poster here (not you, to be fair – I think it was UltraVires) who seemed to suggest that US health care is so messed up because it’s over-regulated and hasn’t been allowed to operate as a true unrestricted free market. This is essentially saying that we should look at what all of the rest of the industrialized world is successfully doing, and then do the exact opposite.
You’re deliberately focusing on the “government run” and ignoring the “universal” in UHC. Nobody is asserting that government-run healthcare programs are somehow better purely on the basis that they are government-run. The same inefficiencies and fraud that mar the private sector currently mar public healthcare too. The point is that universal healthcare programs are better, and more efficient, and that they only work if run by the government.
So if you could drop this particular red herring, this conversation will be much more constructive.
The savings come, again, from the inclusion of everyone. “Doubling” the current programs will not produce cost savings, apart from marginally reducing potential fraud. It would have other benefits, of course.
What the hell are you talking about?
Ah. American exceptionalism. An argument that brooks no dissent nor indeed substantiation.
Part of time you’re arguing that UHC doesn’t work and part of the time that it might work elsewhere but not in the US and part of the time you’re just complaining about Medicare and/or Medicaid minutiae. I’m getting worn out chasing this goalpost around the field.
Again, you’ve seized on a factoid that is entirely irrelevant and are trying to build an argument around it.
And yet, I didn’t say that regulation was the only or even the primary reason that the US healthcare system isn’t a free market system. You simply assumed that part. I am curious though. I mean, you said earlier in the thread (and in earlier threads) that the US private healthcare system is unregulated (granted, ‘compared to other countries’, but still). Should be a slam dunk to prove that and demonstrate, to yourself and probably most other posters that this would be a good reason why it’s a ‘free market’ system.
Ok, so you admit that you didn’t actually mean it’s a free market system at all, just using short hand (incorrectly but since your target audience is seemingly ignorant of what a ‘free market’ even is, it’s understandable) for private for profit. The rest is blah blah blah, but that’s kind of what I’ve been saying. I’m not denying that a large part of the US healthcare system is at least quasi-private…and certainly for profit. You basically shouldn’t have responded to me earlier, since you seem to have been arguing something completely different than what I was responding too, which was that the US healthcare system demonstrates that free markets are flawed and ‘suck’, etc etc.
Again, to be clear, I’m not saying that the healthcare system we have is not broken. It most certainly is. I’m not saying that a different system might not be better. Nearly anything would be better than what we have. I’m simply saying that what we have is not a free market system…and this isn’t because it’s highly regulated (which it is), or even simply because it has some regulation…I don’t think that ‘free market’ by real world definitions means ‘zero regulation’.
At any rate, we don’t seem to have anything more to argue about, as I’m mainly in agreement that the US system sucks, Canada has a better system, and the US would be better off with something else, assuming we could get there. We probably disagree on how easy that would be or what it would entail, but that’s not what the thread is about, which is some loopy attempt to repackage socialism to make it palatable…when, if the focus is on healthcare, the real effort should be in squashing the vast ignorance that equates single payer healthcare or similar programs as ‘socialism’, which it isn’t.
Another tactic is to remind people of great popular socialist experiments in American history such as the Homestead Acts, which gave away over 10% of the United States’s surface area, at 160 acres a pop, to over 1.6 million (white) families.
I had a Nebraskan Senator block me on Twitter when I countered his idiotic “socialism is bad, der” rant when I pointed out to his opponent that 45% of his state was given away and how is he going to argue anti-socialism, but pro-Homestead Act… “what definition of ‘socialism’ doesn’t involve free land?” On the other hand, his opponent? They followed me.
Can you show me which part of socialism involves the government giving away land?? I’ve seen articles in the past claiming this, but I have no idea where they get the idea that this was socialism. Seems the opposite, since basically it was taking federal land (collectively held by the people) and giving it to private individuals who would be required to demonstrate their use of the land to keep it. Can you walk me through how the Homestead Acts are socialist, and where in the definition of socialism or writings about socialism this stems from?