Universal Healthcare

I am often irked at liberals who couch their arguments in favor of universal healthcare in terms of morals. I don’t know that I believe it’s a basic human right (although I definitely don’t support letting people bleed to death in the street), but that doesn’t mean that it isn’t a good idea. Conservatives, or rather people opposed to UHC are of the opinion that they are taking care of themselves and their loved ones, why should they be forced to look after people they don’t know who they may believe (usually wrongly) that they made their beds and now they can lie in them. How does UHC benefit them? A policy that promotes something that they favor, like increasing the overall wealth of society (by increasing worker portability, for instance) could be crafted and would be much easier to sell to the majority of Americans. That said, I don’t know what such a policy would be, but I don’t think appealing to altruism, or calling people who oppose UHC evil is effective.


Why should people without children have to pay to educate the children of others? Why should people who take the responsibility to keep their homes in good repair and safe from fire have to pay for fire departments? Why should people in x-location help to pay for freeways in y-location where they will never go?

Because all of these things are good for the General Welfare that the Founding Fathers specifically sought to promote. I do think that UHC is part of the social contract. It is a benefit that all citizens should receive for the contributions they make to society. Since healthy people tend to be more productive, UHC is good for productivity. Since people tend to spend money when they have it, UHC is good for the economy because people will have money to spend. Fewer bankruptcies caused by medical catastrophes mean fewer houses on the market depressing prices.

It’s not like a balance beam. Many things are interconnected in a web.

It is in large part a moral issue.

The polls I’ve seen show that the majority of Americans already support UHC. This isn’t about a lack of public support for UHC; it’s about how corrupted by money the system is and how utterly spineless the Democrats are. The Democrats are so terrified of the Republicans that they’d rather risk losing their jobs at the hands of an angry constituency than stand up to them.

As far as I can tell, nothing is effective; so we might as well be honest.

The point I am trying to make is that this is how to promote UHC as opposed to claiming that it’s the moral thing to do. Hyperbolic arguments about how Republicans are pure evil and too powerful to be opposed except on internet message boards do nothing to advance the cause.


At least half of what Johnny L.A. posted is claiming that UHC is the moral thing to do. He just didn’t use the word “moral”.

And I see no evidence that the anti-UHC people care in the slightest that it would save money, or that it’s even possible to convince them that it would. Instead, when presented with the evidence that it does they go into denial mode. It’s an article of faith to them that UHC is bad.

What evidence? I consider myself better informed than the average American (maybe not the average Doper) but I am unaware of this. I am not saying it doesn’t exist, but rather that it should be shouted from the rooftops.


The fact that it’s cheaper everywhere that it’s been tried, which is one reason why the rest of the world is there or heading there. America pays more for worse health care. This is the point in the conversation where the anti-UHC people tend to pull out the “America is uniquely incompetent” argument; everyone else on the planet can pull off UHC, but not us.

Taiwan might be used as evidence.

Everyone is covered, care is equivalent to the U.S. and Canada, and it costs half of what it does in the U.S.

You want a selfish argument? If someone close to you without insurance gets ill, someone you love and care about, are you going to put forward the money, or are you going to watch them suffer?

The way the system is set up now, you have to be destitute to get on aid. And once that happens, you don’t have enough money to live, you are ill so you can’t work, and SSDI is a pittance - so maybe your loved one gets on Medicaid because they’ve gone bankrupt paying their bills, but now, are you going to have them live in your basement and feed them, plus pay for all the stuff not covered?

So are you saying that if you got sick and your insurance company just arbitrarily decided that your life was literally worthless to them and you were thus condemned to die because of a balance sheet, you’d be okay with that? That’s moral to you?

When we compare the healthcare systems of other nations, is it an apples to apples comparison? Is the lower cost of healthcare directly related to the fact that they have national healthcare systems?


Or differing liability standards? Different standards of living resulting in different pay for nurses, orderlies, and hospital staff? Different medical standards of care?

I was speaking with a friend yesterday who is considering medical tourism as a way to more affordably meet her needs. The procedure she is looking at costs around US$100K in Miami. It costs about 1/10th as much in India in a private hospital.

AFAIK India does not have UHC. The price difference would seem to be attributable to those other differences.

I’d just like to point out that as an Australian I find the concept of having your health insurance tied to your employer strange, and in fact a restraint of trade.

When an American says “I’d change jobs, but I don’t think I’d be able to find another job with the same healthcare benefits”, that, to me, is a failure of the free market. That person could be working in a more productive position, but they’re not. That’s inefficient.

How many millions of job applications are there in the US every year? Even if each of those applicants only spends an average of 15 minutes having their prospective employer explain the company healthcare plan, that’s still millions of man-hours wasted that simply aren’t wasted under UHC. That is also inefficient.

To me, those are hidden costs of not having UHC, which I never see factored into the debate.

This is an utterly specious “argument” (although, in that regard, it is typical of most objections raised by Americans to UHC, nearly all of which are just a matter of confusion, or the deliberate sowing of confusion). Facts (if they even are facts) about the cost and quality of private health care in India are completely irrelevant to considerations of how the availability of UHC in first world countries affects the cost and quality of health care there. All the evidence from first world countries (and there is lots of it, from nearly every first world country) clearly shows that UHC systems are able to deliver high standards of care (comparable to or better than US standards) for a fraction of what they cost in the USA. Even some third world countries with UHC (most notably Cuba - also a major destination for medical tourism, incidentally) manage to have high standards of care, comparable to US standards, for a tiny fraction of what it costs in the USA. Doctors and nurses, in UHC countries are not starving, either. They may not be raking in the cash quite as fast as as some American doctors do, but they do fine. Is your argument that UHC would be bad for America because not so many American doctors would be able to afford Rolls-Royces?

Nobody is comparing our costs to India. We compare our costs to Europe. In 2005 US healthcare costs were $5,635 per person. (Cite). Costs for Sweden were $2,520. If you think Sweden is cheaper then the US, you should visit some day. (This is on page 2 of the linked article).

Not necessarily. Some are quite obviously direct results of an UHC system : less overhead costs for instance (profits from private insurers, but more importantly nobody having to waste time figuring out what is or isn’t covered or fighting with insurers since everybody is on the same page).

Some are probably related but difficult to precisely figure out : for instance, people with healthcare are more likely to see a doctor early and as a result their ailment should normally be easier and less costly to cure. But assigning a figure to that is going to be difficult.

Some are often tied to an UHC system but aren’t necessarily part of it. For instance spending more on prevention or negociating the price of drugs.

Some aren’t related to UHC per se but to others differences in the healthcare system. For instance if most hospitals are public, hence not in concurrence with each other, they can pool ressources. Three public clinics might have only one MRI machine between themselves, while three private clinics wil have an incentive to each have one machine and to use it for as many people as possible to amortize the cost.

Some are completely unrelated to UHC : For instance you’ll pay more to see a doctor in the USA in part because he expects to make more money than his European counterpart, because he pays much higher insurance premiums due to the “lawyer-culture” in this country, because he has loans to reimburse instead of having benefited from a free education/training.

ETA : And of course, there are intangible benefits to an UHC system. The most obvious being peace of mind about one’s or one’s loved ones healthcare, or the often mentioned ability to quit a job without without having to consider the issue of healthcare. But that’s a different issue.

I’d encourage folks to take a look at this representation - note the four drop down options at the top left of the map:

I am a centrist who sees UHC partly as a matter of morality but mainly as a matter of cost savings. As others point out, true UHC (but probably not “Obamacare”) reduces costs. (For example “From August 1997 to August 2007, employment in the health insurance industry grew an astounding 52%, from 293,000 to 444,000.”)

In a very real sense, it is the conservatives who make UHC a peculiar matter of morality. Despite that the non-healthcare spending power of even a typical insured American would rise under UHC, the (non-ignorant) conservative wants to ensure, based on moral grounds, that those who cannot afford healthcare do not get it.

If they do look at the issue in those terms then it’s not even the most selfish way to look at it. This is how that really works:

How best can I make sure my genetic inheritance survives: given what we know about how radically and surprisingly wealth and opportunity can peak and fall (in families) within even one or two generations, how can I guarantee my genetic survival?

Put another way, what I have now (in the UK) is the gift of my grandparents and my great-grandparents, the people who voted for all this in 1946. They gifted it to unborn generations of which I am one example.

My parents and grandparents made sure it wasn’t tampered with, and it is my responsibility to make sure it continues for the next unborn generations, of my currently middle class family.

I have no idea of the life and financial circs of those generations to come, but I know what I have to do to give them every chance of enjoying decent health - of my genetic inheritance surviving.

Fwiw, I don’t see it in those terms but, if I was really concerned only about ‘me’ I’d weigh that information carefully.

It’s a lot more than 15 minutes. Every year something called open enrollment comes around and millions of workers sit at their desks researching doctors and insurance plan options. I used to spend days (not minutes) doing this, most of the time just to discover that there was no better option and that I would just stay with my current plan.