No-one actually does that. Even Canada, who got the closest, had that struck down in court. As you pointed out. Which country are you talking about?
Canada still has laws that discourage private care and so far the decision only applies to Quebec. Canadians still must come to the US to get around waiting lists. It’s not necessary. Canada is more than wealthy enough to support both private and public health care.
Then what’s your alternative?
You don’t want the government to do this because you fear politics.
You admit that current pension funds already disinvest “all the time” for political reasons.
It sounds to me like you expect each individual to make their own investment decisions, never mind the average person isn’t qualified to be an investment professional, and devil take those who make a bad decision.
Here in the US if you have neither insurance nor immense wealth you might not even get on the list. If you need an organ transplant you won’t even be considered for one if you don’t have insurance or millions of dollars - in Canada everyone has a shot at a new organ if needed regardless of wealth.
Oh, and when my mom needed her first heart surgery it was still experimental, so she was put on a waiting list and the doctors estimated they’d get to her in six months. It was actually four because so many ahead of her died waiting.
So this notion that there is no rationing in the US, or that we all have access to the system, or that there are no waiting lists here is not and never has been true. We just use different criteria to determine where people stand in line - or if they are even allowed in the line at all.
For a lot of things people actually can wait. I have a Canadian friend who needed hernia surgery and yes, he was put on a waiting list. Because most hernias aren’t emergencies, and in fact, some people put off getting them repaired for years even when they could have it done immediately. My friend was monitored by his doctor during the wait so that if some complication arose he could be moved up, even to the front of the line if needed. So he got his surgery at arguably the finest hernia specialist hospital in the world with no out of cost pocket to him and he’s quite happy about the whole thing. Sure, there are a lot of horror stories out of Canada, there are a lot of pleased people, too. Just like in the US there are horror stories and happy stories.
Look at the statistics. By many measures of health the US is inferior to a dozen other nations. Only ideology could lead one to keep saying we’re best in the world. We’re not. It’s time to admit it and change what we’re doing.
Yup. We should decouple health care from employment. This is a critical step to do so.
Wrong. Most first would countries (other than the US, Canada, and UK) have government mandated insurance but each person can choose among a variety of options, usually provided by for-profit insurance companies. Poor people get subsidized and may have fewer options, but they get a guarantee of a basic level of care.
This is much better situation than the one we have, which itself is an improvement on what we had prior to recent healthcare mandates.
I pretty much agree with this, only adding a mandate that people hold insurance, requirement that insurers offer coverage, and some form of subsidization for the poor.
Although, I disagree with you on the factual question of whether the government can run things well. SS has very low overhead for what it does. The IRS is surprisingly efficient and much less evil when you actually have to deal with them than I would have expected.
It varies a lot by country, in many countries (for example, I think this includes Switzerland, Japan, Netherlands) there are large private or semi-private insurers that compete within large geographic or other demographic blocks, and each person chooses among them.
I’m not sure what you’re hoping to accomplish by repeating an argument that’s already been knocked down quite thoroughly in this very thread. But whatever–I’ll knock it down again.
There is indeed a big difference between having my boss decide what to health care to offer me and having the President of the United States forcing me to have a particular type of health care. If I don’t like the health care that my boss is offering, or if I don’t like anything else that my boss is doing, I can walk into her office and discuss the matter with her. I’ve done so many times to talk about many issues. Of course there’s no guarantee that my boss will adjust her decisions based on what I say, but at least she’s willing to listen and the possibility of change is there.
If I don’t like the health care that President Obama is forcing me to buy, I’m out of luck. He’s not willing to listen to me personally. He doesn’t care about my opinions. If I tried to walk into his office, some large guys with guns would physically prevent me from doing so.
That is the difference between health care based on individual decision-making versus health care controlled by the federal government.
Technically Germany is multi-payer, but for practical purposes the health insurance system functions as single-payer because all the statutory (public) “sickness funds” are so tightly regulated that they may as well be a single entity. There is a private insurance system as well but only a small minority are even eligible for it, let alone interested in it, and I believe only about 10% utilize it, nor is it all that dramatically different from the public system. Germany has a long history of social solidarity that makes comparisons with anything in US health care misleading and largely irrelevant.
The Chaolli case you’re referring to in Quebec was a very narrow ruling applying only to Quebec and to a specific set of circumstances. What is interesting is that in response, Quebec drafted a special law permitting private health insurance for those specific instances that were pertinent to the court ruling, and at last report the total number of individuals who had purchased this private insurance was… precisely zero!
The number zero comes up in other instructive contexts in Canadian health care, too. Every province and territory actually has the right to opt out of the Canada Health Act and go the merry route of private health insurance for medically necessary procedures if they so desire and if that’s what the people want. The total number that have done so: zero.
I also note that Canada presently has just about the most conservative right-wing pro-business pro-free-market government in living memory. But it’s a government that is astute enough to be able to read the tea leaves of public opinion. The chances that it could abolish the Canada Health Act and privatize single-payer health care: zero. It’s a non-starter and has never been up for discussion, even in this wingnut government.
Of all the things Americans misunderstand about Canada, the whole issue of single-payer health care in Canadian provinces is probably one of the most egregiously misunderstood, and that’s largely because of the sordid PR efforts of industry lobbyists like AHIP and conservative media.
Exactly right – the triage process that guarantees timely health care for urgent acute cases is absolutely key and makes wait lists essentially nothing more than an inconvenience.
BTW, no doubt the hospital you’re referring to is the Shouldice Hospital in Toronto. They are indeed a world class hernia center and have patients from all over the world, primarily from the US. The current wait time for typical elective hernia surgery is about three weeks, and that applies to everyone, including US visitors with private insurance. I’m sure that many who pontificate about how Canadian health care works would be surprised to learn that Shouldice is a private for-profit hospital.
My boss has zero control over my health insurance. That’s up the CEO and the HR department. I work for a large company. My governor is about as accessible as the CEO, and is more interested in constituent opinions, since he cares about being re-elected. My county reps are a LOT easier to see face-to-face for personal concerns than is my CEO.
The notion that the PotUS would be personally making your health decisions is beyond ludicrous. Do you think Queen Elizabeth II dictates to the UK’s NHS? (If I recall correctly, they’re actually made by a group called NICE).
The PotUS would no more make health policy on his own than the PotUS decides policy on airspace use on his own. Try actually studying what other countries do rather than making ridiculous kneejerk assumptions.
Correct, he had his operation done at Shouldice, which is a wonderful example of how you can have excellence and innovation under a single-payer system.
I have exactly two choices of health care at my work. And let’s just say with over 10,000 employees I’m not about to walk into the offices of anyone who makes these decisions and get anything changed.
I have not had to go to the California site, but my understanding is that there are a lot more than two choices. And for many people ACA offers a lot more choices than they had before, which was none.
The President helped design and then signed the ACA, which both forces (almost) every person in the country to purchase health insurance and severely micromanages what sort of insurance we can legally buy. If an individual were either to prefer to not be insured, or wanted a type of insurance that’s not allowed under the ACA, he or she would be out of luck. The President is not willing to talk personally with us or address our individual concerns.
I have no clue what Democrats would do in such a hypothetical situation. I just know what Democrats spend a lot of time vowing that they’re going to protect women from a great many threats, most of which are entirely imaginary or greatly exaggerated. The “threat” of evil employers trying to snatch away their employees’ birth control in one obvious example. (Republicans on the other hand rarely assert that either gender needs a whole lot of special federal protections. It seems they credit women with sufficient intelligence and strength to survive without being coddled by the government.)
Really? When exactly did I make any mention of a health insurance policy that covered just reproductive health? I certainly don’t recall mentioning any such thing.
Sometimes, boys and girls, after you grow up you realize that, as an adult, you occasionally have to do things you don’t like because of society and the greater good. Like buckling your seat belt and motorcycle helmets (where mandatory) and lighted exit signs in theaters and food preparation and sanitation laws.
People who refuse insurance, unless they have some means to fund treatment potentially running into the millions, are lunatics. It’s as intelligent as sky-diving without a parachute or bungee jumping with worn out bungees. Hence why the rest of the civilized world mandates coverage paid by taxes.
Far more common than someone wanting insurance that’s not covered is someone wanting coverage but not being able to afford any without the ACA and its subsidies.
You said that if someone works for a company that doesn’t offer reproductive health services with the medical coverage they could go elsewhere for it. Are you seriously saying they shouldn’t be allowed to purchase a rider for reproductive health? Except I don’t think such a thing exists. Given our current jacked-up “system”, if it did I’d assume it would be prohibitively expensive for the working poor.
Let me translate that from conservative-speak to English. It’s saying that if someone whose income level is sufficient to buy health insurance wants to be so recklessly stupid as to not have health insurance, then he will be assessed a small tax liability for said stupidity. (Considering the tremendous cost to the system of uninsured deadbeats showing up in emergency rooms, I consider that the recklessly stupid should actually be assessed large penalties.)
It’s also saying that insurance plans with so many exclusions that they’re next to useless are no longer available.
It’s true that the ACA is very far from perfect and is in fact an unholy mess. But that’s because conservatives insist on driving all health care through private insurance systems. The ACA is less of a mess than the virtually unregulated abomination that existed before.
Good point. That insurance companies have leverage to get lower prices is similarly irrelevant. If you want lower prices, get your (preferably sickly) friends Bob and Fred to negotiate together with you.
Bone’s clever argument can end much of the silly debate on the message board:
Don’t like the service on an airline? Buy your own plane! Have nitpicks about Google’s policies or algorithms? Write your own search engine!
Do you think that the mandates under the PPACA are based upon the recommendations of the government’s own experts? They aren’t.*
My objection to the policy requirements are that the government chooses to politicize decisions about coverage. To me it is every bit as arbitrary as the private sector system pre-PPACA with none of the freedom to allow the consumer a real choice.
- The Discretionary Advisory Committee on Heritable Disorders in Newborns and Children of the U.S Department of Health and Human Services recommended coverage for certain specialized food used solely in treatment of patients with metabolic disorders but Secretary Seibilus declined to take action on that recommendation. In this case food * is* medicine. Taking the wrong food can cause serious, permanent, and costly-to-treat medical conditions.
We’re still waiting. Think she waited for a survey of employers before deciding on other essential benefits?
Actually the point is that if you want to enjoy the benefits of volume negotiation there are tradeoffs. One of those is that the insurance company is involved to an extent the nature of coverages offered and associated pricing. To believe otherwise is naive.
And the line of thought that prompted this comment was the notion that somehow insurance companies were intruding between the relationship between patient and doctor. In reality, the consumer (patient), insurance company, and the doctor have an intertwined relationship. There is no way to characterize the arrangement as intrusion since all parties are voluntarily and willingly engaging in that relationship.
There it is again.
No, the patient is NOT the consumer from the viewpoint of the insurance industry, the EMPLOYER is the consumer. So it’s not the neat triangle you paint of doctor-patient-insurance, it’s really doctor-patient-employer-insurance.
And given that very, very few individuals can truly afford medical insurance outside their employer without heavy subsidy no, it is NOT voluntary on the part of the patient. There is considerable coercion going on there that the politically right conveniently doesn’t see.
This is correct. One minor niggle is that hospitals also play a large part in the equation. So the three-legged stool is:
- Doctor/hospital,
- Patient/employer,
- Insurance plan (who have negotiated pricing for everything with said doctor groups and hospitals, and then market/sell these “networks” to the employer).