# 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:** 3
**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, 3:09pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/41 "2009-01-27T15:09:12Z")
[QUOTE=Really Not All That Bad] Just about everyone in the northern half of England is part of the nominal “underclass”. [/quote] :dubious: Hardly, despite repeated references to the “industrial north” by London based media companies, when most of the north is rural, and any excuse to do a “special report” from Manchester on “Gun crime UK” when there’s another shooting in London. Yeah, there’s areas of deprivation, but the majority of northerners aren’t belonging to an underclass like **brazil84** describes it! ---
**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, 3:10pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/42 "2009-01-27T15:10:13Z")
> [@catsix](#): > > 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. > > 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. How much are you putting away? COBRA can be incredibly expensive. I’ve seen quotes as high as 2K a month. That can be difficult to manage when an unemployment check is $200 a week. ---
**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, 3:10pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/43 "2009-01-27T15:10:41Z")
> [@Jayn\_Newell](#): > > 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… I don’t think it’s particularly relevant to discuss how you’d get UHC countries to switch to private care. I mean, it’s not going to happen anyway. I had considered the potential for additional turnover or even emigration, but then I looked at the numbers, and it turns out that the US is already suffering a severe nursing shortage, and med-school enrollment caps enforced in the 80s and 90s mean we’re about to enter a severe doctor shortage too. Plus, some states are already experiencing doctor shortages- Florida, for one- because of the ever-more-ridiculous cost of malpractice insurance. > [@](#): > > Yeah, there’s areas of deprivation, but the majority of northerners aren’t belonging to an underclass like brazil84 describes it! Shh! You’re ruining my argument! 😉 It would be more accurate to say that there are areas of wealth, no? ---
**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, 3:42pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/44 "2009-01-27T15:42:55Z")
[QUOTE=Really Not All That Bright] It would be more accurate to say that there are areas of wealth, no? [/quote] No. The percentage of households receiving benefits in the North West is 27%, and for Yorkshire 24%. London’s figures are 24%. Similarly, mean income in the NW is £20,483, in the West Midlands it’s £20,563 and in the East £20,868. The South West has a mean of £20,950. Much of a muchness outside of London, yet I can’t recall anybody persistently painting the South West as chronically deprived. It’s the presence of the super-rich in London, mostly due to the concentration of financial services there, that differentiates mean income in London from the rest of the country. (I just noticed I mistyped your name in my previous post.) ---
**Author:** ![tagos](https://avatars.discourse-cdn.com/v4/letter/t/bbe5ce/32.png) [@tagos](https://boards.straightdope.com/u/tagos)\ **Post date:** [January 27, 2009, 3:52pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/45 "2009-01-27T15:52:27Z")
> [@Capt.Ridley\_s\_Shooting\_Party](#): > > The South West has a mean of £20,950. Much of a muchness outside of London, yet I can’t recall anybody persistently painting the South West as chronically deprived. The SW is the epicenter of rural poverty and the focus of complaints and pleas for decades. That’s why they want a motorway and an improved rail system. ---
**Author:** ![pbbth](https://avatars.discourse-cdn.com/v4/letter/p/f9ae1b/32.png) [@pbbth](https://boards.straightdope.com/u/pbbth)\ **Post date:** [January 27, 2009, 3:54pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/46 "2009-01-27T15:54:50Z")
> [@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. Wait, in [this thread](http://boards.straightdope.com/sdmb/showthread.php?p=10653994&highlight=disability#post10653994) you talk about being on disability and receiving checks from the government and, I would assume, government medical care for all of the disabilities you mention having. So, basically you are saying that the reason we shouldn’t have universal health care is because of people like you? ---
**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, 3:56pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/47 "2009-01-27T15:56:45Z")
> [@Capt.Ridley\_s\_Shooting\_Party](#): > > (I just noticed I mistyped your name in my previous post.) I kinda like the **Ridley** ized version. 😃 **“Really Not All That Bad”** > [@tagos](#): > > The SW is the epicenter of rural poverty and the focus of complaints and pleas for decades. That’s why they want a motorway and an improved rail system. If you’d ever tried driving on the A37, or had to change trains at Exeter St. David whether or not you were going West… ---
**Author:** ![Xan](https://avatars.discourse-cdn.com/v4/letter/x/ac8455/32.png) [@Xan](https://boards.straightdope.com/u/Xan)\ **Post date:** [January 27, 2009, 3:59pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/48 "2009-01-27T15:59:13Z")
My only real concerns are that the government will use UHC to make sweeping bans on foods or activities because it’s paying for healthcare. I’ve heard people make the same argument that they should be able to tell people on welfare what they can eat/drink/whatever because their taxes are paying for it. My other concern is that healthcare is, like everything in life, scarce. By scarce I mean there is a finite amount of medicine, doctors, equipment, etc. UHC won’t change that fact. If we do adopt UHC we should try do something like this: [Ernest Madu: Bringing world-class health care to the poorest](http://www.ted.com/talks/view/id/249) Now this guy is talking about doing this in the 3rd world. He’s already done it in Jamaica. Essentially he’s made affordable and world class health care by making smart technical choices such as modular equipment and hospitals networked together. Now mind his centers are private but this could be applied to government run healthcare. I highly recommend everyone watch this video. Are there any estimates on how much UHC will cost each person in taxes per year? ---
**Author:** ![Bridget\_Burke](https://avatars.discourse-cdn.com/v4/letter/b/7cd45c/32.png) [@Bridget\_Burke](https://boards.straightdope.com/u/Bridget_Burke)\ **Post date:** [January 27, 2009, 4:10pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/49 "2009-01-27T16:10:00Z")
> [@Xan](#): > > My only real concerns are that the government will use UHC to make sweeping bans on foods or activities because it’s paying for healthcare. I’ve heard people make the same argument that they should be able to tell people on welfare what they can eat/drink/whatever because their taxes are paying for it. > > My other concern is that healthcare is, like everything in life, scarce. By scarce I mean there is a finite amount of medicine, doctors, equipment, etc. UHC won’t change that fact… Do you have info on the “sweeping bans” enacted in the many other countries with UHC? Why not train more doctors? Medicine & equipment are manufactured–they are not irreplaceable natural resources. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [January 27, 2009, 4:12pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/50 "2009-01-27T16:12:12Z")
> [@Jayn\_Newell](#): > > Maybe, just maybe, UHC would help the underclass move up to working class? Doesn’t the underclass already get taxpayer-funded health care, thru Medicaid? > [@](#): > > 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. If you are still talking about the underclass, I don’t think they are going bankrupt paying for their own healthcare. But your point about preventative care is not as convincing as it might be. The federal government already spends [hundreds of millions of dollars](http://www.fda.gov/fdac/reprints/vaccine.html) on taxpayer-funded vaccinations for children. Yet substantial numbers of children - [from 37 to 56%](http://www.enotalone.com/article/8174.html) - are unvaccinated. One would think that if there was a pent-up demand for preventative care, those rates would be higher, and the [costs of vaccine-preventable diseases in adults](http://www.medscape.com/viewarticle/561704) would be negligible. THe rest of my objections are the usual - [ul][li]People who now have no coverage would be covered - i.e. demand goes up. Generall, when demand goes up, cost goes up.[_]Economies of scale - there are very few programs of the federal government which are more efficient and less costly than the private sector. Compare, for instance, the US mail with FedEx. FedEx has to be prevented by law from directly competing with the US Postal service.[_]The major reason health care costs go up is that the consumer is shielded from the cost. It is perceived, therefore, as “free”. This happens now with employer-funded health care. It would continue or increase with taxpayer funded health care.[\*]There is currently much complaining about how HMOs only care about getting the patient out the door at minimum cost. See the recent uproar about discharging new mothers from the hospital after twentyfour hours. The medical outcomes, on average, were no worse for a twentyfour hour discharge than for the traditional fortyeight hour. Yet, in 1996, laws were passed requiring insurance companies to cover for the longer stay ([cite - PDF](http://content.healthaffairs.org/cgi/reprint/16/3/198.pdf)).[/ul][/li] This is not to say that UHC cannot possibly work. It is merely reason to suspect that a direct transplant of the UK health plan to the US may not lead us to the Promised Land of a decrease in health care costs. Regards, Shodan ---
**Author:** ![tagos](https://avatars.discourse-cdn.com/v4/letter/t/bbe5ce/32.png) [@tagos](https://boards.straightdope.com/u/tagos)\ **Post date:** [January 27, 2009, 4:31pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/51 "2009-01-27T16:31:54Z")
> [@Really\_Not\_All\_That\_Bright](#): > > I kinda like the **Ridley** ized version. 😃 > > **“Really Not All That Bad”** > > If you’d ever tried driving on the A37, or had to change trains at Exeter St. David whether or not you were going West… Fully familiar. Grew up there. Family still there. ---
**Author:** ![Xan](https://avatars.discourse-cdn.com/v4/letter/x/ac8455/32.png) [@Xan](https://boards.straightdope.com/u/Xan)\ **Post date:** [January 27, 2009, 4:46pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/52 "2009-01-27T16:46:19Z")
> [@Bridget\_Burke](#): > > Do you have info on the “sweeping bans” enacted in the many other countries with UHC? > > Why not train more doctors? Medicine & equipment are manufactured–they are not irreplaceable natural resources. I didn’t say it would happen. I’m just paranoid like that. I fully admit it’s an irrational fear. I see your other point though. ---
**Author:** ![Spoons](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spoons/32/3141_2.png) [@Spoons](https://boards.straightdope.com/u/Spoons)\ **Post date:** [January 27, 2009, 4:47pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/53 "2009-01-27T16:47:28Z")
> [@wolfman](#): > > A lot of the cost of U.S. healthcare is because of enormous Malpractise insurance costs costs… 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. Just to clear this up, at least for Canada: Health care providers in Canada carry professional liability (i.e. malpractice) insurance. Patients who feel they are victims of malpractice can and do sue their health care provider; and if they win their case, the malpractice insurer pays the claim. There are, as far as I am aware, no laws limiting how much a patient can sue for in malpractice claims; although it should be noted that awards generally follow common-law precedent regardless of how much is originally claimed. But Canada’s adoption of a single-payer system did not result in anybody “signing away everybody’s right to sue.” It still exists. ---
**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, 4:59pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/54 "2009-01-27T16:59:26Z")
> [@](#): > > **LavenderBlue** said: > How much are you putting away? COBRA can be incredibly expensive. I’ve seen quotes as high as 2K a month. That can be difficult to manage when an unemployment check is $200 a week. In order to get the coverage that I have now, I would have to pay 470$ a month. Considering that I have stashed away enough money to live for two years, should that amount double it would shorten the amount of time I could survive without any additional income, but not so much so that I’m worried about it. > [@](#): > > **Jayn\_Newell** said: > Pretend for a second that you are in their country. Why? I’m not, and I have no intention to be. One of the things I like about living in the US is that taking care of yourself is supposed to be your own damn responsibility. Although, I’m not so happy about the decline in that attitude. ---
**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, 4:59pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/55 "2009-01-27T16:59:48Z")
> [@Shodan](#): > > The federal government already spends [hundreds of millions of dollars](http://www.fda.gov/fdac/reprints/vaccine.html) on taxpayer-funded vaccinations for children. Yet substantial numbers of children - [from 37 to 56%](http://www.enotalone.com/article/8174.html) - are unvaccinated. Can I just nuance your interpretation: “are not fully immunized by age 2” is what the article says. It also mentions that there are “as many as 16 doses in about five visits to the doctor before a child’s second birthday”. Which is somewhat less negligent behaviour than your rephrasing appears to make it. Part of this may be due to the non-universality of such an offering, if the article is to be believed: “Only half of health insurance plans cover childhood vaccines, though **many** public health departments offer them free or at a reduced fee based on income.” My emphasis. Not quite how I initially read what you were saying. IMO you have every right to be annoyed if throwing half a billion dollars at the problem isn’t done within a comprehensive, universal, and relatively efficient framework. Could I therefore also theorise that the low takeup rate may possibly be due to unfamiliarity with universal-style healthcare? In the UK, where it’s expected, and there is a free-at-delivery clinic for all children, and a program kicked off by the midwives/doctors/nurses. In the UK, despite all the MMR/autism scare nonsense, in 2004/5 there was an [81% takeup rate](http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/takeup-of-mmr-vaccine-shows-first-rise-in-a-decade-507973.html) for this innoculation. Prior to the scare, it was 92%. > [@](#): > > Economies of scale - there are very few programs of the federal government which are more efficient and less costly than the private sector. Compare, for instance, the US mail with FedEx. FedEx has to be prevented by law from directly competing with the US Postal service. 1. Do you think the US Federal government is any less efficient than the UK government (I don’t). 2. What about a federally-funded healthcare system that is run by competing private sector organisations? That would certainly remove the concern about inefficiency, and allow competition. I believe Israel runs such a system. ---
**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, 5:16pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/56 "2009-01-27T17:16:48Z")
> [@catsix](#): > > Why? Because you seem to think that UHC is inherently worse. If it is, then you shouldn’t have too much trouble coming up with arguments to convince someone under such a plan to want to change. Tell me, why should I prefer the mess of a system the US has now to what I enjoyed north of the border? It sure as hell isn’t costing me less. ---
**Author:** ![Xan](https://avatars.discourse-cdn.com/v4/letter/x/ac8455/32.png) [@Xan](https://boards.straightdope.com/u/Xan)\ **Post date:** [January 27, 2009, 5:21pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/57 "2009-01-27T17:21:43Z")
> [@catsix](#): > > In order to get the coverage that I have now, I would have to pay 470$ a month. Considering that I have stashed away enough money to live for two years, should that amount double it would shorten the amount of time I could survive without any additional income, but not so much so that I’m worried about it. > > Why? I’m not, and I have no intention to be. One of the things I like about living in the US is that taking care of yourself is supposed to be your own damn responsibility. > > Although, I’m not so happy about the decline in that attitude. To be fair if you use insurance you’re not really paying for just yourself. The losses are pooled among a large group. ---
**Author:** ![BrainGlutton](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@BrainGlutton](https://boards.straightdope.com/u/BrainGlutton)\ **Post date:** [January 27, 2009, 5:24pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/58 "2009-01-27T17:24:35Z")
> [@Boyo\_Jim](#): > > The spending we’ve been doing on the Iraq war shows just how laughable the arguement is that we can’t afford universal health coverage. We can afford practically anything we want to afford. No, we **could** afford anything. Before the war. 😉 ---
**Author:** ![Giles](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/giles/32/60_2.png) [@Giles](https://boards.straightdope.com/u/Giles)\ **Post date:** [January 27, 2009, 5:34pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/59 "2009-01-27T17:34:28Z")
> [@GorillaMan](#): > > > [@foolsguinea](#): > > > > But hey, the UK, Australia, Canada, New Zealand, & Germany all have similar cultural heritage, with (Anglophone except for Germany) dominant cultures dealing with racial minorities & lots of immigration at various points mucking that up. And they have similar political issues, being federal systems. And they all make some form of UHC work. > > A minor point, I know, but the UK isn’t a federal system. With power devolving to legislatures in Scotland and Wales, the UK might be mistaken for a federal system – though, indeed, it’s not. However, there is no way that New Zealand could be thought to be a federal system. ---
**Author:** ![buttonjockey308](https://avatars.discourse-cdn.com/v4/letter/b/bcef8e/32.png) [@buttonjockey308](https://boards.straightdope.com/u/buttonjockey308)\ **Post date:** [January 27, 2009, 5:55pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/60 "2009-01-27T17:55:14Z")
The true opposition to UHC isn’t contained in the shallows of the conversations on this board. The reason it will never happen, at least not to the extent that it has abroad is because the insurance lobby is more powerful than most of us know. Further, there are tens of thousands of people employed by the insurance industry, not to mention the many fat-cat CEO’s making outrageous salaries and frankly, the insurance industry is too closely married to our economy via investment to risk putting all the big boys out of work because if they can’t make a margin, they won’t risk the mission. I’m generally for UHC, but I just don’t see it. [Previous page](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193.md?page=2) [Next page](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193.md?page=4)