socialized medicine

Great Debates
21

In Canada, any Political Party that advocated doing away with our public healthcare system would be voted out of existence.
While there are some real problems with the Canadian system, they are generally related to underfunding and/or management bungling, rather than a systemic failing.
There is a far amount of propaganda being bandied about with regard to waiting lists etc. My feeling is that this is largely driven by right wing idealogues, and insurance companies who want to get into this lucrative market. (IMHO)
There are some waiting lists for elective surgery, there is also a problem with the availability of service in some areas.

So, is a public health system something to be feared? Absolutely not!
But you need to hold the politician’s feet to the fire to make it efficient.

22

You mean, in the US, it’s possible for someone to have their house seized because they wanted to stay alive?

You mean, this is the sort of system certain politicians in my country are advocating?

I’ll press “submit reply” now before I start typing things pit-worthy.

23

Please read the posts that followed, gex gex.

24

While it’s true that hospitals don’t frequently go to collections they have the right to do so.

And the exceptions pointed out above are true of almost any indebtedness situations. If one makes an effort to pay back debt (almost any show of good faith) the forfeiture of assets can be avoided.

And bankruptcy tends to protect one’s primary residence in most cases so no, one couldn’t be tossed out of a home for it. But other assets could be seized.

25

Last month I attended the Oasis science-fiction convention in Orlando, Florida, and had the honor to meet Robert J. Sawyer, Canada’s most prominent sf writer (apart from Spider Robinson, who is a Yankee immigrant). I asked him point-blank: Is there any downside to the Canadian single-payer health care system? He replied with a flat “No.” I asked him, what about the doctors in Canada? Are they satisfied with what they earn under this system? He replied, doctors are the highest-paid professionals in Canada. But do they earn as much money as American doctors? No!

I guess that’s the root of the problem. Single-payer healthcare in the United States would not pauperize the doctors, but it probably would drastically reduce their income. So of course the doctors are against it. As are all the health insurance companies, and their investors and employees. And these groups have a lot to spend on lobbying.

26

I don’t know much about Sawyer, but what makes him qualified to be able to give a detailed and competent analysis about the state of the Canadian health care system, other than being a Canadian himself?

27

First let’s ask ourselves: What specific problem are we trying to solve? Then lets ask ourselves: What is it about the way the gov’t functions that would make it a better/worse provider of this service in terms of the problem we are trying to solve?

And of course we have to make sure that the gov’t is actually chartered to solve this problem in the first place. While I would argue strongly that the answer to that last question is “no”, I suppose for the sake of argument here we need to assume that it’s “yes”. After all, the gov’t has pretty much horned in on most other aspects of our lives at this stage in our history.

So, what is the problem we’re trying to solve? I personally have no issue with my health coverage. And, being self-employed, I pay 100% of my premium myself.

28

The main problem we would be solving would be the 40 million people who have no health insurance at all. Why the goverment would be better is because preventative care matters a lot and allows people to focus on their health rather than the cost of their health. There are other problems, but that is the main one.

The goverment is chartered to solve the problem because it is a democracy.

29

Sterra: So, because 40M people don’t have health coverage, the other 220M of us have to have our health coverage nationalized? Why not just give those 40M people some money to buy insurance in the current system? It’s unclear why that wouldn’t solve the problem, as you have defined it, just as well if not better than socializing the whole industry.

30

That would work too, but then the question would be is it better than national healthcare? We do spend a lot more money on healthcare compared to those socalized countries out there. Socializing the industry works and overall it works better than the free market.

http://dll.umaine.edu/ble/U.S.%20HCweb.pdf
Theres a good comparison of our healthcare system to others.

http://www.geocities.com/sterra13/untitled.JPG

You would have to copy and paste this because I couldn’t find the original, but I did a speech on national healthcare a while ago and it shows a good visual comparison of our cost to others.

31

Go back 15 yrs. The US spends more money on bread than the USSR, therefore socialized farming works better than the free market. Do you see the flaw in that reasoning? Bread was dirt cheap in the USSR, but you had to stand in line for hours to get your measly alotment. Perhaps we spend more money in the US because we have more money to spend or because we have a greater availability of certain health care options.

32

I don’t see why “socializing” health care is such a big deal, or why it should have such a huge impact. You can make it as big or as small as you want.

This is how we do it in Norway.

First, you got doctors and you got hospitals.

Doctors are all in private practice. They can choose to join the national health care system if they want, - or not. If they join, the pasient pay a fixed fee to the doctor, and the doctor sends a bill to the government asking for another fixed fee. For example, the government decides that the price for a basic consultation (no blood samples or anything) is $100, and that the pasient must pay $20, the government picking up the remaining $80. Just an example.

If the doctor chooses not to join the national health care system, they charge whatever they like, typically a higher price than doctors within the system.

Remeber, none of the doctors are employed by the state, or the government or something like that.

So, if the government wants more pasients to choose the national health care system, they lower the fee pasients has to pay, and/or increase the amount doctors can charge the government (moving more doctors into the system), and vice versa.

So you can have a small national health care system, or a big one. You choose.

Hospitals in Norway are owned by the state, with a few minor exceptions, but that’s because hospitals are quite good, and it’s rather a large investment to start a private hospital. And as a pasient I usually still pay only a $20 fee at a public hospital. It’s kind of hard to compete with that for private hospitals.

I’ve been both to doctors who are members of the national health care system, and doctors who are not. I’ve also been to hospitals.

Generally, it’s the same treatment. The only difference is that by choosing doctors outside the system I can usually get a same-day appointment whatever the reason for the visit. Another difference is that doctors outside the system always insists on taken a blood sample (thereby upping their fee), even if I only bumped my foot or something.

I don’t know how much of my tax money are going to health care. On another forum, somone living in the US mentioned that they paid $1,000 a month for their familiy. Is this true? And if so, what’s the amount on an average paychek

33

There are other problems too that stem from a very basic fact: The interests of the sellers (insurance companies) and buyers in this marketplace are not well-aligned. In particular, the insurance companies want to insure people who are not likely to get sick and the people who want insurance most badly are those likely to be sick.

This means that if you have a “pre-existing condition”, insurance companies will refuse to cover you, will not cover that condition, or will charge exorbitant rates. In practice, one can often get around this with insurance provided by a job since that is often group insurance where you won’t run into these problems. But, then you are tied to your job in order to have insurance (although COBRA, which is a government law, can help tide you over for 18 months).

I know a bit about this because when I was in grad school, the school’s health insurance policy had a cap on what they would pay (like $25,000?) so students banded together and got an insurance company to offer us a catastrophic policy we could buy into with a $25,000 deductable so it would pay for anything beyond that. I tried to buy into this but when I told the agent I had kidney stones, he told me it would be considered a pre-existing condition and I would not be covered for it. He then said, “You had just 1, right?” and I said, “Well, no, I have actually passed 3 of them so far” and he looked in his book and said that I was “NCA” (no coverage available)…The best he could do is write me an accident-only policy.

34

JSHORE:

Well, in a free market system the seller is always trying to get the highest price and the buyer is always trying to get the lowest price. This is not unique to health insurrance. If I’m selling you a car and know that you must purchase one today (a pre-existing condition) I’m less likely to let you bargain down the price than if I think you have a lot of time to shop around and make a decision.

Seems like your problem is related to portabiltiy. Why is it that we don’t buy health insurance like we buy car insurance? You start off with a clean slate in car insurance, and go from there. I’d suggest that our system which allows companies to give health care insurance as a non-taxable benefit locks us into a situation where health insurance is tied to your place of work rather to you as a person. If health care insurance was bought with after tax income (like most other things), then you’d buy into it at an early age and carry it without having to start all over everytime you changed employers.

35

Certainly if people are less satisfied with healthcare under socalized systems that would be true. The thing is it is the opposite. We beat Italy in people satisfied with healthcare.

We also tend to not live as long and we have a higher mortality rate. So in this case we are like Russia only the bread costs more.

36

John-

I think your analogy breaks down when you look at long term trends in health care insurance. With a growing number of insurers tightening up their policies (to avoid payouts, as is there right) and the growing cost of health care (in excess of the rate of inflation) we’re in a position where the current system is not long term sustainable. Sooner or later we’ll be faced with only people who will never claim anything getting insurance (at any price) and the vast majority who will not.

And that’s a revolutionary situation that leads to major changes in health care funding and systems.

Really, again, no one has addressed my concerns that the issue isn’t the cost or availability of health care insurance but rather the disincentive to cost savings on the part of health care providers.

Once again, what other industry would we tolerate its rates going up at several multiples of inflation each year? Suppose food did that and year one bread would cost $1, year 2 $2, year 3 $4? Or gasoline?

We’d have legislation (probably misguided legislation) in about 2 weeks.

But with health care, because insurance picks up so much of the cost of the voting public (those without health insurance also being most likely not to vote or make campaign donations) the growth is partially invisible.

If health insurance consumers had to pick up most of the cost of their health care you’d begin to see true market pressures come into play in the health care field so fast you’d get whiplash trying to follow it.

So, IMHO, the proper focus is not on bringing the market to bear (libertarian that I am) on health insurance but bringing those same forces to bear on health care.

37

The fact that this question is being asked is really weird to me. Is the fear of the welfare state that great in the USA?

Right now whether or not people get treatment in the US is dependent on how much money they have, but it is hard to accrue large stores of cash when you are unwell (even for those who accept the rhetoric that anyone can have a job if they want one).

How can any system be more unfair than that?

If you find that the US government is not providing adequate health care under a public plan, perhaps suggest that they shift their priorities from weapons and space travel back to their own citizens.

38

JC:

Why not just raise the deductibles? Doesn’t that accomplish what you feel needs to be accomplished? And again, doesn’t the whole system we have where health care is generally provided as a non-taxable work related benefit also contribute to the problem as you define it?

The experience I have of the gov’t providing a service to the consumer (in a monopoly or semi-monopoly) is the post office and the school system. Not exatlly shining examples of quality and efficiency. The more you remove competition from the framework, the more expensive or the less available something will become.

Any system that allows people more choice is going to be better than one that doesn’t. I’d rather see the gov’t pay for private insurance for poor people than to have it take over the health care industry.

The fact of the matter is that many advances in medicine are outrageously expensive. Assuming that all possible care should be available to all possible people is just not realistic. Rationing is going to occur either by the gov’t or the marketplace. One can choose which system of rationing one prefers.

39

I can’t understand you people.

Nearly every single person from a country with socialized health care expresses satisfaction with their system. There is plenty of evidence that for at least 40 million people, our system does not work at all. I am one of those people. I cannot afford things like check-ups, appointments when I am sick, dental cleanings, eye exams, medicine- nothing. I am uninsured and I don’t have the ability to pay for any sort of health care on my own. God forbid I get in an accident. It would ruin my life. Scares the hell out of me.

Why do you insist on holding on to a system that doesn’t work on a grand scale when there is another system that does work?

40

And it scares the hell out of me to think there are millions of people like this, many of them working in service industries and spreading god-know-what illnesses all over the place because they aren’t insured and can’t afford treatment for whatever contagion they’re suffering from.

[inflammatory rhetoric]
I wonder how all the opponents of “socialized medicine” would feel if their kid died of SARS contracted from some minimum wage cashier at the airport McDonald’s who couldn’t afford to see the doctor about his cough.
[/inflammatory rhetoric]