Subsidized health care? What about gas, water, etc.

Great Debates
1

First of all, it’s not “universal health care”, it’s universal health insurance. Any American can get basic health care via free clinics or the charity work many doctors do. What if you have a major problem and you don’t have insurance? No problem. Just go to the local hospital that has to provide basic care and then don’t pay the bill. People do this ALL the time.

I’m may be an ass but I feel that after a bachelor’s degree and two master’s (working my way through school each time) and the numerous certification tests I’ve had to take, maybe I have earned having my company subsidize my health insurance. Hell, tell me any other job other than teaching that requires so much education and certification and pays a barely living wage. A subsidized health insurance is the least they can give me.

Plus anyone can get health insurance. OK, maybe not if you have a pre-existing condition. But wait, can I get car insurance after the accident to fix my car? Maybe there is a reason that insurers don’t cover pre-existing conditions. “I never bought your insurance but I’m pissing blood now so let me start my premiums and get full coverage.” :dubious: And if insurance is too expensive . . . see the solution in paragraph 1.

Now I’m not a complete bastard, but why do we focus on health insurance for everyone and ignore the true necessities of life? Why is there no push for the government to provide universal electricity, water, phone or gas? Those are more necessary for daily life and can be quite expensive. These bills are a disproportionate percentage for low income families and even for middle income, it is a large monthly expense.
So for GD,

  1. What would improve the life of low AND MIDDLE income America the most, subsidized health insurance or subsidized water, electricity, and natural gas?

  2. Explain to me why we shouldn’t subsidize water, electricity, and natural gas with bonus points if the exact same arguement cannot be used against subsidized insurance.

  3. Extra credit if you can justify not subsidizing water, electricity, and natural gas (and maybe health insurance) while justifying the subsidies we give corn farmers.

2

Water, electricity and natural gas (well, utilities in general) are improved by innovation when driven by profit. Companies, through competition, will seek out technological advances to deliver their product more efficiently. If these innovations prove successful, they spread through the industry to the general benefit of all.

Health insurance, though, is a mature industry. It is not driven by efficiency and in fact benefits from being slow to respond.

3

Good Heavens.

Are you sure about that? Are you arguing that the pumping of water and the generation of electricity are rapidly innovating, leading-edge industries that benefit from loose flows of capital, whilst healthcare is not? It’s hard to see what you’re getting at.

Artificial limbs and joints, arthroscopic surgery, spinal fusions with plastic materials, gene therapy and in-utero surgery didn’t even exist a short time ago. Now some of those things are commonplace. Are you claiming that somehow the industry benefits by not rolling those products and services out as fast as possible?

Please explain that one to me.

4

If you think the deserving poor are in need of resources, they why not just give them resources? Give them money, and then deregulate the markets you describe in the post above and let them optimize their own decisions.

If they have a lot of kids and need schooling, they can spend their money on schooling.

If they want to live in a cold climate and need to spend money on heating oil, they can spend it on that. Potentially at the tradeoff of having a lot of kids.

If they want to work from home and need to be wired up to broadband Internet, they can spend money on that. Potentially at the tradeoff of having a lot of kids, and/or living in a cold climate.

Why do you want to take the next step beyond that, and get into the business of picking and choosing what is most important to them?

What makes you think you (or a government official) can somehow divine what combination of needs and preferences optimize their personal outcomes, and therefore you should be at the tiller of directing resources this-way-and-that, rather than giving them the choice?

Because once you do, the electricity industry, the gas industry, the school industry, and every other industry will start lining up outside Capital Hill, looking for favors, protection from competition, extra subsidies, tax breaks, etc. to distort the market to their advantage.

Oh wait. That’s how it works today. Never mind.

5

Subsidize from where? Where is the government getting all this money to provide all these socialized services?

6

Because utilities are relatively cheap compared to healthcare costs. You can live without electricity or phone service. But all of a sudden you might need treatments that cost $10,000s of dollars.

7

Services such as the fire department and police department?

8

Easily. I wasn’t talking about healthcare, but healthcare insurance.

For emphasis: healthcare insurance.

9

First off, water and energy are daily requirements that most of us can meet, and the hassle for individuals to avoid paying for them is much greater than the hassle to void the bank account to maintain their supply. Consequently the high number of contributers to the infrastructure of water and energy delivery keeps the price down to a reasonable level.

Health care is a completely different animal. I hear that 47 million people in the States do not have health care insurance. That is damn near 1 in 6. And these people do get serviced in hospitals and that cost is is reflected in actual payable hospital bills (read insured bills), and those charges are reflected in insurance premiums.

And then there are the young people who “don’t need health insurance”. They are not contributing. Their contributions could lower premiums for everyone else. But eventually when they do need it or perceive to need it, they don’t get health care/get subsidized health care or pay huge premiums later.

The main idea behinduniversal insurance is to share the costs over a lifetime. When everyone pays through taxes and mandatory premiums from the time they are old enough to earn income, the cost to each individual is much lower.

Ever think about the many people who live in cities and hardly ever get out to use the highways? Is it fair that they have to support the highways through their taxes? What if we put tolls on the outskirts of cities so that only those who use them pay for their financing and maintenance. Use the arguments against that proposal to support universal health care.

With regard to the corn farmers, I would assume that their subsidies come in the form of tax breaks, which if they didn’t get would result in less tax revenue over all through loss of business.

10

Anybody who’s ever been camping can tell you that, no, utilities are not “necessary for daily life”. Ten years ago after a hurricane I went two weeks without any utilities but water. It was a hardship, but not life-threatening.

Furthermore, we have a high degree of control over how much of these services we use. If you’re really trying to cut down on your water usage you can do things like only showering once a week. If your gas bill is too high you can turn down the thermostat and wear more sweaters in winter.

But medical expenses aren’t something you can easily scrimp on. If you’re a diabetic you can’t say “Well, I need to save money so I’ll just give myself an insulin injection once a week.” If you break your leg, you can’t say “Hmmmm … going to a doctor is too expensive. I’ll just set it myself.” Unlike our consumption of electricity, gas, etc., we have very little descretion with medical expenses, so the invisible hand of the free market ceases to function properly.

11

Because your daily bread, water, clothing, shelter and so on are PREDICTABLE expenses.

Insurance is for UNPREDICTABLE expenses. Sure, you could save hundreds of thousands of dollars against the possibility that you’ll need it if you get colon cancer. But the odds are that you won’t get colon cancer. But what if you do?

And so you get insurance for unpredictable expenses, like your house burning down, or an auto accident, or getting sued for malpractice, or a major illness.

We mandate that anyone who drives a car MUST have auto insurance, because we know that without this mandate there are millions of people who will get into accidents but be unable to pay for the damage they cause. We don’t know in advance who these people are, but we know that there will be a predictable number of them. Sure, you could just suppose that people will pay for any accidents they cause. But we know for a fact that lots of people don’t have much money. If they get in an accident they could cause thousands and thousands of dollars in damages. And if they’re broke, they’re judgment proof. We don’t have debtor’s prisons. So if the broke guy who destroys your BMW and puts you in the hospital can’t pay, you’re going to have to pay for it yourself.

Similarly, we know that people will get sick, we just don’t always know who will get sick. And we know people won’t have saved enough money to pay for their illness. Is it fair to require hospitals and doctors to treat those sick people for free?

Or is it more fair to require everyone to have health insurance? And if we require everyone to have health insurance, but they can’t get health insurance because private industry won’t sell them a reasonably priced individual policy, then we have to provide some sort of public health insurance.

And here we are.

12

The initial premises on which you are basing your questions are flawed. I haven’t even gotten to the debate part of your post yet. Insurance companies often have exclusions on paying for the treatment of pre-exisiting conditions. However, that’s if they’ll give you coverage at all. I have relative whom the insurance companies will not touch. Never mind that he hasn’t needed anything more than basic care for the past 25 years; he’s missing too many chunks of his insides for them to even consider.

And as for your “free” care in paragraph 1. That’s already subsidized. And it’s costly. It’s cheaper to pay for someone to go to a GP to get a strep swab and antibiotics than it is to wait until their kidneys are fried.

13

Sigh, do we have to dig up this canard again? Fine. Preventative care may be good for you, but it will not save us money.

14

Righto, I should have specified that it may not save money overall. Just that “free” right now is not free.

15

That article only says that: 1) the cost studies so far are not conclusive; and 2) preventive care is not free (amazing!).

16

Except that’s not the plan, which is to charge a surtax on the wealthy to pay for UHC. Even now, without UHC, everyone is not paying, in fact, an estimated 47% pay no federal income taxes at all.

17

In my city, water and electricity are provided by a public utility, and the price and quality are both as good as, if not better than, those provided by private companies in other areas.

18

Yes, yes, conservatives want to shift more taxes onto the freeloading poor. It’s one of those points that when conservatives say it among themselves, they are being philosophical about the relationship between citizen and state, and when Democrats say it about Republicans, there’s squeals of “You don’t understand the Chicago school of economics!” or whatever.

I agree with the point that spending money to give preventative care to 10,000 when maybe only 1,000 may not look great in the ledger, but let’s not miss seeing the forest for the trees: most people would say that healthier lives are a societal benefit that is more substantial than what accountants can appreciate.

19

One reason socialism doesn’t work well is that people are wasteful when they’re not paying the bill. If the govt subsidized gas, people would keep their houses warmer in winter, wouldn’t worry about letting cold air in, or turning down the thermostat when their away. Same for electricity and air conditioning and lights. Free water and we leave the irrigation system on even when it’s raining.

If the govt paid for car or home insurance, people would take risks they wouldn’t otherwise take. There’s no problem with the rates going up. There’s an issue now in NC about the state subsidizing insurance for beach houses that wouldn’t be cost effective to build when the cost of hurricane damage is taken into account.

But health care is different. Except for a few hypochondriacs and lonely old people, nobody wants health care they don’t need. I don’t want an appendectomy just because it’s free. And I don’t take unnecessary risks just because hospital care is cheap. Some doctors and hospitals might try to pad the bill by doing unnecessary things, but that’s happening already with private insurance.

One place they can get the money is from all the money they save in emergency room treatment that would be done in doctor’s offices instead.

20

Health care is expensive and people don’t want to pay for it. That’s the basic answer.

In the old days say 50 years ago, there weren’t treatments for many diseases. You’d go to the doctor, he’d figure out you have cancer and say “go home and get your affairs in order”. Now, they’ll spend whatever it takes to cure you and often can (if you have insurance). Of course, tests, operations, nurses, drugs all cost money. And many people in the US don’t have a lot of money so they want someone else to pay for this stuff. That’s basically it.

All the “spread the costs over everyone” kind of makes sense except that it’s hard to make everyone pay. The healthy 20 somethings (much of the uninsured) don’t want to pay huge rates for something they won’t use. How would you feel if you had to buy life insurance at 20 years old but it was priced for the average 60 year old? You’d be paying 10x too much money, actuarially adjusted.

I do have sympathy for the uninsurable due to previous medical conditions. Companies don’t want to insure them because they are high risk. If they take in those people they’ll have to jack up their rates and will be uncompetitive. Soon they’ll ONLY have those sickly people and the rates will be unaffordable to anyone. That’s called “antiselection” spiral.

Not sure what can be done about that. I guess you could have some kind of gov’t insurance pool for them…and require them to spend down their assets to be fair. That is kind of like medicaid though.

As for the “if everyone pays” it will be cheaper overall. I don’t think that makes arithmetic sense. It will be cheaper for 40 somethings if healthy 20 year olds are paying into the system…of course 20 somethings may not have 5,000 per year they can pay.

Which brings into the real issue I think. It isn’t just mandatory insurance, it’s mandatory insurance that many people won’t have to pay for. It’s a freebie. Pretty easy to win votes promising poor people gold plated health care they won’t have to pay for.

Back to the OP, what if someone is REALLY POOR? No car, no house…etc. Health care is “essential”. Well so is a car, gasoline, a house, clothes, etc. I guess you could live in a cardboard box, but I could see the gov’t say, providing a “guaranteed income” to people from general tax revenues of say 10,000 per person. Including kids. Then where would the gov’t get the money to pay for it? From the working stiffs! Create incentives for people not to work and then put the costs on the suckers who still do work. That’s kind of what happened with welfare…eventually I think it would be irresistable to gov’t to do this. They would just buy votes outright. “Vote for me, I’ll up your guaranteed wage to 12,000 per year!”. Then tell the gov’t workers unions that they’ll get a raise too. The cop who arrested Gates made almost 200K last year, did you know that? A cop? I mean, I’m all for cops, but 200K?

There is an old saying some founding father made about how the country will exist until people figure out they can vote themselves as many goodies out of the treasury as they want. Then it’s finished. Twelve trillion in debt? How many accrued pension benefits for gov’t workers? Medicare obligations? Annual deficits of 8% of GDP, 1 trillion dollars.

I read that in the 1920s the gov’t took in 3% of the GDP. Now state, local, and federal it’s about 40%.

We may be finished already.