# USA really too different from English-speaking world to have similar policies? **URL:** \ **Category:** The BBQ Pit\ **Created:** [January 27, 2009, 6:04am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193 "2009-01-27T06:04:59Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![brazil84](https://avatars.discourse-cdn.com/v4/letter/b/8491ac/32.png) [@brazil84](https://boards.straightdope.com/u/brazil84)\ **Post date:** [January 27, 2009, 10:15am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/21 "2009-01-27T10:15:51Z")
> [@foolsguinea](#): > > Are you equating underclass with “minority”? No, but there is a strong relationship between “underclass” and non-Asian minorities, i.e. blacks and hispanics. > [@](#): > > Do you contend that our 30% non-white population somehow makes us more like S. Africa than like Canada? Somewhere in between. If national health care were to be implemented and work well in South Africa, I would withdraw my objection to national health care in the United States. > [@](#): > > Wait, we shouldn’t have UHC because we have gun crimes? No, I am against UHC because there is large underclass in the US. Murder rate is a rough proxy for the size of the underclass, at least in western nations. ---
**Author:** ![brazil84](https://avatars.discourse-cdn.com/v4/letter/b/8491ac/32.png) [@brazil84](https://boards.straightdope.com/u/brazil84)\ **Post date:** [January 27, 2009, 10:17am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/22 "2009-01-27T10:17:01Z")
> [@foolsguinea](#): > > I find it interesting that you used 30% both for “Black & Hispanic” & for “underclass.” Please show me where I used 30% for “underclass.” Thank you. ---
**Author:** ![Dead\_Badger](https://avatars.discourse-cdn.com/v4/letter/d/848f3c/32.png) [@Dead\_Badger](https://boards.straightdope.com/u/Dead_Badger)\ **Post date:** [January 27, 2009, 10:18am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/23 "2009-01-27T10:18:32Z")
I think his point is that black and hispanic people have completely different internal organs to white people; UHC in such a heterogeneous internal environment would be prohibitively expensive. You’d need white spleen doctors, black spleen doctors… it’d be madness, particularly when you’ve got to arm them all to fight back the hordes. Incidentally, the UK solved this problem by utilising members of the underclass; it created a system of indentured servitude and renamed them “junior doctors.” ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [January 27, 2009, 10:24am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/24 "2009-01-27T10:24:48Z")
> [@brazil84](#): > > Please show me where I used 30% for “underclass.” Thank you. oops. never mind. ---
**Author:** ![jjimm](https://avatars.discourse-cdn.com/v4/letter/j/ba8739/32.png) [@jjimm](https://boards.straightdope.com/u/jjimm)\ **Post date:** [January 27, 2009, 10:28am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/25 "2009-01-27T10:28:09Z")
I’d just like to add Hong Kong into your mix - capitalist paradise (albeit with strong regulatory fundamentals) with very low income and corporation tax, no capital gains tax, vast numbers of immigrants, and… well I never: “socialized” medicine! ---
**Author:** ![Capt.Ridley\_s\_Shooting\_Party](https://avatars.discourse-cdn.com/v4/letter/c/cc9497/32.png) [@Capt.Ridley\_s\_Shooting\_Party](https://boards.straightdope.com/u/Capt.Ridley_s_Shooting_Party)\ **Post date:** [January 27, 2009, 10:35am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/26 "2009-01-27T10:35:23Z")
Crime rates in South Africa and USA aren’t even remotely like each other. Intentional homicide rates for South Africa were 38.6 deaths per 100,000 in 2006, whereas the same rates for USA were 5.7. For comparison, Britain’s rates were 2.03 per 100,000, although both Scotland and Northern Ireland, taken on their own, were slightly higher. The idea that success in South Africa is in any way indicative of success in USA is the most bizarre thing I’ve ever read. Comparing a nation who has relatively recently emerged from Apartheid, with all the social problems that causes, and where a substantial number of people still, unfortunately, live in abject poverty, with the richest country in the world—that’s a new one on me. I can only surmise that the comparison is so laughably idiotic because it’s a target that was chosen precisely because it could never possibly be met. As always, do not feed the troll. ---
**Author:** ![Caught\_Work](https://avatars.discourse-cdn.com/v4/letter/c/919ad9/32.png) [@Caught\_Work](https://boards.straightdope.com/u/Caught_Work)\ **Post date:** [January 27, 2009, 10:59am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/27 "2009-01-27T10:59:31Z")
Australia has something like 21M people. > **[Census](https://www.abs.gov.au/census?opendocument?utm_id=LN)** We don’t have millions of people looking for immediate and urgent healthcare. Also, life threatening heath care is provided immediately, but if your heath problems are not life threatening (even if they are painful, annoying and require you to never leave your home because you need a new hip) the waiting times for surgery on the public health system are horrendous. ---
**Author:** ![brazil84](https://avatars.discourse-cdn.com/v4/letter/b/8491ac/32.png) [@brazil84](https://boards.straightdope.com/u/brazil84)\ **Post date:** [January 27, 2009, 11:10am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/28 "2009-01-27T11:10:40Z")
> [@Capt.Ridley\_s\_Shooting\_Party](#): > > Crime rates in South Africa and USA aren’t even remotely like each other. I agree. Similarly, the US has a much higher murder rate than Canada. ---
**Author:** ![jjimm](https://avatars.discourse-cdn.com/v4/letter/j/ba8739/32.png) [@jjimm](https://boards.straightdope.com/u/jjimm)\ **Post date:** [January 27, 2009, 11:13am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/29 "2009-01-27T11:13:17Z")
> [@brazil84](#): > > I agree. Similarly, the US has a much higher murder rate than Canada. Due to an underinvestment by the government in its people. /facetious ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [January 27, 2009, 11:43am UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/30 "2009-01-27T11:43:54Z")
Wait, so is the argument that we have so many “underclass” (nice euphemism, by the way. “Urban” is so nineties.) people shooting each other that we can’t afford to treat them on a national health service? Who the fuck do you think is paying for their gunshot wounds now? Taxpayers, through Medicare and hospitals’ charity programs (which are only possible because of tax cuts for the hospital and billing inflation for the rest of us.) It’s not like we’d be adding ON the “underclass” people shooting each other, we’re already paying for them. We’d be adding on a gazillion more mostly healthy people paying in more than they use, just like right now they pay in more than they use to their health insurance every month. Plus, of course, I’d love to see a cite that there are that many gunshot wounds treated every day, at that high an expense. I’d be shocked to find it more expensive than obstetrics or oncology or cardiac management…y’know, those \*nice \*medical expenses that “respectable” citizens incur. ---
**Author:** ![Isamu](https://avatars.discourse-cdn.com/v4/letter/i/7c8e57/32.png) [@Isamu](https://boards.straightdope.com/u/Isamu)\ **Post date:** [January 27, 2009, 12:38pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/31 "2009-01-27T12:38:09Z")
> [@Caught\_Work](#): > > Australia has something like 21M people. > [Census Information](http://www.census.abs.gov.au/AUSSTATS/abs@.nsf/Web+Pages/Population+Clock?opendocument?utm_id=LN) > > We don’t have millions of people looking for immediate and urgent healthcare. Also, life threatening heath care is provided immediately, but if your heath problems are not life threatening (even if they are painful, annoying and require you to never leave your home because you need a new hip) the waiting times for surgery on the public health system are horrendous. Sure, but that’s the basic minimum EVERYONE is provided. You can, if you choose, pay a bit more for private care and get immediate treatment for anything, right? ---
**Author:** ![catsix](https://avatars.discourse-cdn.com/v4/letter/c/e19b73/32.png) [@catsix](https://boards.straightdope.com/u/catsix)\ **Post date:** [January 27, 2009, 1:00pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/32 "2009-01-27T13:00:22Z")
> [@](#): > > **Isamu** said: > Sure, but that’s the basic minimum EVERYONE is provided. You can, if you choose, pay a bit more for private care and get immediate treatment for anything, right? Even if that’s the case, there’s little incentive here for people who do have health insurance they’re happy with. What would you do to entice people who have the immediate, private care and don’t want to spend more on a public care system that they will see no benefit from? ---
**Author:** ![Jayn\_Newell](https://avatars.discourse-cdn.com/v4/letter/j/f9ae1b/32.png) [@Jayn\_Newell](https://boards.straightdope.com/u/Jayn_Newell)\ **Post date:** [January 27, 2009, 1:37pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/33 "2009-01-27T13:37:30Z")
> [@brazil84](#): > > No, I am against UHC because there is large underclass in the US. Murder rate is a rough proxy for the size of the underclass, at least in western nations. Maybe, just maybe, UHC would help the underclass move up to working class? My biggest beef with the current system in the US is that it discourages preventative care. The effect on the poor here is two-fold: 1. They stay sicker longer, and if they have a chronic condition, it doesn’t get treated properly if at all. 2. When they do seek care, the cost is crippling. The latter has ripples through the system–who do you think pays for their care when they can’t? In one form or another, the rest of us. How about we just pay for it upfront, skip the part where they go bankrupt, and entice them to see a doctor more often to prevent minor problems from becoming major, more expensive ones? I wouldn’t be surprised to see UHC push costs down. I have a hard time seeing the downside to this. ---
**Author:** ![Capt.Ridley\_s\_Shooting\_Party](https://avatars.discourse-cdn.com/v4/letter/c/cc9497/32.png) [@Capt.Ridley\_s\_Shooting\_Party](https://boards.straightdope.com/u/Capt.Ridley_s_Shooting_Party)\ **Post date:** [January 27, 2009, 1:54pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/34 "2009-01-27T13:54:52Z")
> [@brazil84](#): > > I agree. Similarly, the US has a much higher murder rate than Canada. What _are_ you talking about? Britain and the US have comparable violent crime rates. The US and South Africa do not, with nearly a whole order of magnitude difference. It’s very simple. Success in South Africa isn’t needed to demonstrate that UHC can work, when there’s already functioning health systems in other, similar, countries, that haven’t been recently emerged from the blight of decades of Apartheid, and the social ills that it causes. Similarly, relative violent crime rates in Canada and America are a lot closer than relative violent crime rates in the US and South Africa. There’s only one reason you suggested South Africa as a model for American health care, and that’s to engage in your brand of sophistry and circumlocution. ---
**Author:** ![LavenderBlue](https://avatars.discourse-cdn.com/v4/letter/l/e95f7d/32.png) [@LavenderBlue](https://boards.straightdope.com/u/LavenderBlue)\ **Post date:** [January 27, 2009, 1:57pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/35 "2009-01-27T13:57:13Z")
> [@curlcoat](#): > > I don’t know about the rest of those countries, but the Canada I knew even 10 years ago and the Canada my husband was born in doesn’t have hundreds of thousands of people laying around expecting the government to take care of them. The Canadians I know take care of themselves, live responsible lives and all that. > > The US probably has more people sitting around on the dole than there are people living in Canada. The US is a country where those “without” expect those “with” to give them things simply because they want them, because they have this idea that they “deserve” these things. Without earning them in any way. > > The Canadian government doesn’t have a history of (that I know of) paying for $500 toilet seats, useless wars and all the other crap the US wastes taxpayer money on. The Canadian government doesn’t have a history of lack of success in running nationwide health insurance plans like the US does with Medicaid and Medicare. > > Using other countries as examples of whether or not national insurance would work cannot ignore the differences between those countries and the US. It’s like saying that very little insulation in a home’s walls will work everywhere because it works here where the temperature range is 40 degrees to 80 degrees. You’re a fucking moron. We spend more than just about any nation on the fucking planet. In turn we get shorter lives and more health care expenses. > [@catsix](#): > > Even if that’s the case, there’s little incentive here for people who do have health insurance they’re happy with. What would you do to entice people who have the immediate, private care and don’t want to spend more on a public care system that they will see no benefit from? The guarantee that they aren’t going to lose their health insurance if they lose their job. Also (if I’m not mistaken) under most proposed plans they’d get to keep their insurance anyway. ---
**Author:** ![Isamu](https://avatars.discourse-cdn.com/v4/letter/i/7c8e57/32.png) [@Isamu](https://boards.straightdope.com/u/Isamu)\ **Post date:** [January 27, 2009, 2:30pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/36 "2009-01-27T14:30:10Z")
> [@catsix](#): > > What would you do to entice people who have the immediate, private care and don’t want to spend more on a public care system that they will see no benefit from? I don’t need to ‘entice’ anyone to do anything. Let me play your question back on you - what would you do to ‘entice’ people in universal healthcare systems to adopt a US style system ? ---
**Author:** ![catsix](https://avatars.discourse-cdn.com/v4/letter/c/e19b73/32.png) [@catsix](https://boards.straightdope.com/u/catsix)\ **Post date:** [January 27, 2009, 2:46pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/37 "2009-01-27T14:46:04Z")
> [@](#): > > **Isamu** said: > Let me play your question back on you - what would you do to ‘entice’ people in universal healthcare systems to adopt a US style system ? I wouldn’t. Their country, their choice. The only reason I give a damn at all about whether we have health insurance tax in the US is because it directly affects me. > [@](#): > > **LavenderBlue** said: > he guarantee that they aren’t going to lose their health insurance if they lose their job. Also (if I’m not mistaken) under most proposed plans they’d get to keep their insurance anyway. So these people didn’t read their COBRA rights did they? Quite frankly, one of the things I put away for in the event I do lose my job is paying for health insurance. ---
**Author:** ![wolfman](https://avatars.discourse-cdn.com/v4/letter/w/a8b319/32.png) [@wolfman](https://boards.straightdope.com/u/wolfman)\ **Post date:** [January 27, 2009, 2:50pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/38 "2009-01-27T14:50:36Z")
Lawyers. A lot of the cost of U.S. healthcare is because of enormous Malpractise insurance costs costs. It’s been a well known fact for 30 years that the only way to fix health care is to first fix the civil legal system. And politicians , who include a large numbers of Lawyers are loathe to do anything. Plus there are morality rights issues with just signing away everybodiy’s right to sue. But that is what basically has to happen to move to the system toward other countries models, or affordablility have. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 27, 2009, 2:52pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/39 "2009-01-27T14:52:54Z")
> [@Jayn\_Newell](#): > > I wouldn’t be surprised to see UHC push costs down. I have a hard time seeing the downside to this. Single-payor systems _always_ push costs down\*. Single-payor systems also push the standard of care down a bit. I say this as the son of a GP and a surgeon who, combined, practiced medicine in (UK) NHS hospitals and clinics for ~sixty years. However, having seen both sides of the coin, I would take universal health care in a nanosecond. There’s a bit of a disconnect between the folks being Pitted here. **curlcoat** is simply ignorant. **brazil84** is totally effing crazy. There are myriad reasons why UHC might not work in the US. However, neither of those reasons are “we have too many black/Hispanic/poor people,” or “we have too many people sitting around on the dole”. Just about everyone in the northern half of England is part of the nominal “underclass”. The US and UK unemployment rates are generally just about identical, and the US rate is usually a hair lower. \*Economies of scale generally offset bureaucratic costs. In addition, single-payor systems don’t have to employ the legions of billing staff, lawyers and so on that multi-payor systems require. Plus, natch, medical staff would be paid _much_ less. We’re not talking police/teacher-type salaries, but your average orthopaedic surgeon has a very, very good reason to oppose universal healthcare. ETA: **wolfman** , UHC systems spend a lot of money on malpractice suits too. The difference is that lawmakers generally take steps to limit the amount of damages a malpractice plaintiff can seek. Also, the cost of insuring against such falls on the health system (or hospital), not the doctor, who is generally going to be immune from such suits. ---
**Author:** ![Jayn\_Newell](https://avatars.discourse-cdn.com/v4/letter/j/f9ae1b/32.png) [@Jayn\_Newell](https://boards.straightdope.com/u/Jayn_Newell)\ **Post date:** [January 27, 2009, 3:03pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/40 "2009-01-27T15:03:01Z")
> [@catsix](#): > > I wouldn’t. Their country, their choice. Pretend for a second that you are in their country. **RNATB** , now I remember one of the downsides–it can be harder to keep medical staff because of the lower salaries. Granted, usually when I hear this argument come up, the staff in question is moving to the US, so… [Previous page](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193.md?page=1) [Next page](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193.md?page=3)