# 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:** 4
**Author:** ![VinylTurnip](https://avatars.discourse-cdn.com/v4/letter/v/b2d939/32.png) [@VinylTurnip](https://boards.straightdope.com/u/VinylTurnip)\ **Post date:** [January 27, 2009, 6:07pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/61 "2009-01-27T18:07:52Z")
> [@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? For starters, I guess I’d wreck the economy, causing massive unemployment… ---
**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, 6:11pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/62 "2009-01-27T18:11:25Z")
> [@catsix](#): > > 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. So your local fire and EMS services have been apprised that you’ll go ahead with your own house fires, then? > [@buttonjockey308](#): > > 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. Insurers and their associated industries are already preparing for UHC. My fiancee works for a third-party employee benefits administrator, whose main function is managing health plan enrollment for their clients (some of which are gigantic enough that outsourcing employee benefits seems very odd to me - the Federal Reserve System and a well-known big-box electronics store, for example). One of their big priorities now is identifying and training employees to explain the Canadian single-payor system to clients, in the event that it comes here. There was no similar program 10 years ago. ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [January 27, 2009, 6:15pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/63 "2009-01-27T18:15:47Z")
> [@Caught\_Work](#): > > Australia has something like 21M people. > [ > 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. These horrendous waiting times for surgery don’t exist in all countries with an UHC system. It’s not an unavoidable result of UHC. ---
**Author:** ![Lamia](https://avatars.discourse-cdn.com/v4/letter/l/8e7dd6/32.png) [@Lamia](https://boards.straightdope.com/u/Lamia)\ **Post date:** [January 27, 2009, 6:19pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/64 "2009-01-27T18:19:44Z")
> [@clairobscur](#): > > These horrendous waiting times for surgery don’t exist in all countries with an UHC system. It’s not an unavoidable result of UHC. FWIW, I’ve sometimes had to wait months to see a specialist (e.g. ophthalmologist, endocrinologist) in the US. Heck, when I was a teenager the only dentist in our part of town who accepted my mother’s health insurance had such a long waiting list that we couldn’t even get our teeth cleaned twice a year. My mother finally would up paying out of pocket for cleanings at another dentist. ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [January 27, 2009, 6:33pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/65 "2009-01-27T18:33:41Z")
> [@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? What makes you feel that they would spend more? Especially taking into account what they pay for their current insurance and tax-funded healthcare expenses? Basically, I’ve a hard time figuring out how a system with private insurers who add a profit on top of other expenses, and add complexities and overhead by each having their own scheme could cost _less_ than a single payer system. The only possible way would be if people saw a doctor more often, etc… But besides the fact that people don’t have expensive surgery just because it’s free, more GP visits, preventive care and so on is a net benefit for healthcare cost. Why do you think that countries with UHC run advertisement campaigns to incite people to be checked up for this or that potential ailment? Hint : that’s not because they expect it to result in _more_ expenses. ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [January 27, 2009, 6:50pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/66 "2009-01-27T18:50:51Z")
> [@buttonjockey308](#): > > Further, there are tens of thousands of people employed by the insurance industry, In those debates, I’m always intrigued by the issue of what would happen to the large insurance companies in the USA if it switched to an UHC system. Of course, there are private insurance companies (\*) over here, but their activity is of course much more limited (overcharging by doctors, dentistry and optics, private rooms in private hospitals, incident costs like income loss, that sort of things). I wonder how an UHC system could be implemented in the US without wrecking these companies. (\*) And again, I’m not going to miss an occasion to point at the prominence of non-profit insurers, ran by the insured themselves, that seem to be sorely lacking in the USA. There’s no way I’d pay an insurer that wants to make a profit, in the running of which I would have no say, and whose primary concern would be its stockholders rather than the insured. ---
**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, 6:52pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/67 "2009-01-27T18:52:41Z")
> [@Jayn\_Newell](#): > > Maybe, just maybe, UHC would help the underclass move up to working class? And maybe if we dump a lot of money into the Kansas City public schools, it will help raise students’ test scores and diminish the gap between blacks and whites. But then again, [maybe not](http://www.cato.org/pubs/pas/pa-298.html) > [@](#): > > 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. I’m somewhat skeptical of this. For one thing, your scenario seems to assume that “the poor” will act responsibly. But anyway, I have no objection to spending more money on Medicaid to make preventative care more available if there is a bona fide savings in the end. And I have no objection to raising taxes on the middle and upper classes to improve Medicaid, as long as the government does not go overboard. ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [January 27, 2009, 6:55pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/68 "2009-01-27T18:55:25Z")
> [@foolsguinea](#): > > It is, at root, because of the Cold War. No, really. That the USA had to be the Arsenal of Democracy, & thus needed to be propagandized & radicalized against Marxist-Leninists wherever they arose. So we were indoctrinated to hate & fear communism, enough to go to the other side of the world into alien environments & kill people we knew nothing about sight unseen to stop it. Although I quite agree with your basic point, I think you’re wrong about history here: In Germany, Universal Health care (plus the other social services, like pensions for people too old to work by a general fund, pensions for widows and orphans from a general fund etc.) were all enacted under Bismark, at the end of the 19th century - before WWI! And Bismark was a rabid anti-socialist - he passed laws forbidding not only communists but also the social democrats (a normal democratic party asking for workers rights, though to US ideas, they would be socalist, I guess). He did it for similar reasons that Henry Ford (apparently forgotten by every US manager since) gave workers a decent wage and weekends off and only 8 hr/days: it made sense in the long run. (Ford correctly guessed that well-paid workers could afford to buy his cars, and with weekends off, had the time to drive the cars; in other words, his employees were also his consumers/customers). For Bismark, the real problems during the early phases of the Industrial revolution caused desperation under the workers which lead to unrest and them joining the communists, so he used the carrot-and-stick tactic: with one hand, he forbid the communists et al., with the other hand he cleaned up the worst excesses and problems - because people who are no longer desperate, but have something to loose don’t rebel. As for why the US can’t have a UHC: my personal opinion is that of a deep down difference in ideology. I compare with the first sentence of Constitiuon as the gist: in Germany, it’s “Human dignity shall not be violated. All state power is dedicated to protect it” (loosely translated). In the US, it’s “life, liberty and pursuit of happiness”. Therefore, in the US, nobody is responsible for anybody else and doesn’t care (local church and similar charity is patchwork on the existing system). In Germany, as in the rest of Europe, people feel that a state is a community of people working together and caring for each other. Also, it’s against human dignity to have people dying like dogs in the street (to exaggerate). The community is responsible for a minimum level for all members. That’s also why I can’t imagine the population ever accepting an offical switch to single-payer over here. (A slow erosion of the services provided under the general UHC, plus additonial private insurances to cover the rest for those who can afford it, seems to be the way it’s going, though.) As for the other arguments - wages, malpractice suits, demand - none of these hold up when looking at countries with UHC, who have lower Healthcare costs for citizens then the US. And no doctors don’t get paid a pittance (they don’t have those incredible debts of private-paid schools at the start of their career, either), and no, if doctors mess up of course patients can sue! You people could have the best system because you can look at half a dozen countries or more and pick-and-choose the best method and look what works where and what doesn’t. But since so many believe the myths and not the facts, I doubt it will happen. ---
**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, 7:07pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/69 "2009-01-27T19:07:43Z")
> [@Capt.Ridley\_s\_Shooting\_Party](#): > > What _are_ you talking about? Britain and the US have comparable violent crime rates. According to [this web page](http://en.wikipedia.org/wiki/List_of_countries_by_homicide_rate), the most recent homicide rates for the United Kingdom and the United States were 2.03 and 5.70 respectively. Canada’s is apparently 1.85. Thus the UK and Canada are about the same, and the United States is nearly triple either one. South Africa is, of course, much higher than the United States. I specifically chose murder rates because reporting tends to be more consistent. > [@](#): > > blight of decades of Apartheid, and the social ills that it causes. To hear some people tell it, the United States is still profoundly affected by the social ills of slavery, as well as our own apartheid which ended only 40 years ago. Can I take it you disagree with such people? > [@](#): > > There’s only one reason you suggested South Africa as a model for American health care, I’m not sure what you mean by “suggested South Africa as a model.” If somebody wants to claim that Canada is comparable to the United States, it’s hardly outrageous, in turn, to compare the United States with South Africa. ---
**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, 7:24pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/70 "2009-01-27T19:24:55Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Just about everyone in the northern half of England is part of the nominal “underclass”. Let’s do this: You pick out the worst major city in northern England in terms of underclassiness and I will do the same for the United States. Then we will compare them. ---
**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, 8:05pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/71 "2009-01-27T20:05:01Z")
You know homicide statistics include justifiable homicides, including police shootings, right? > [@brazil84](#): > > Let’s do this: You pick out the worst major city in northern England in terms of underclassiness and I will do the same for the United States. Then we will compare them. What exactly will this prove? ---
**Author:** ![Captain\_Amazing](https://avatars.discourse-cdn.com/v4/letter/c/6de8d8/32.png) [@Captain\_Amazing](https://boards.straightdope.com/u/Captain_Amazing)\ **Post date:** [January 27, 2009, 8:25pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/72 "2009-01-27T20:25:06Z")
> [@Really\_Not\_All\_That\_Bright](#): > > What exactly will this prove? That black people are criminals. For **brazil84** , the answer is always that blacks are evil. ---
**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, 8:47pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/73 "2009-01-27T20:47:48Z")
> [@jjimm](#): > > Can I just nuance your interpretation: “are not fully immunized by age 2” is what the article says. Sure. I intended to say “children of less than school age”. > [@](#): > > 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. I wasn’t trying to make it sound like negligence. The issue is (as I see it) that people won’t vaccinate their children in order to preserve their future health, let alone because it will save health care dollars in the long run. So if they don’t do it now (and the underclass is especially prone to not vaccinating in childhood) even though it is paid for by the government, I doubt that further involvement of the government in health care will trigger an intense desire to get your kids up to date on their shots to hold down health care inflation. What forces people (by and large) to get their kids vaccinated at last is that it is required before your kids can get into public school. Which raises an issue mentioned elsewhere - the temptation for government to expand its power over its citizens in the name of health care. We see that tendency now with regard to things like smoking. The usual rationale for anti-smoking rules and non-smoking areas and so forth is that second-hand smoke impacts other people. I expect that less than two years after UHC is implemented, there will be calls from someone to ban smoking in private homes - in order to save money. And followed quickly by calls to ban fast food, lack of exercise, and the other factors that make health care in the US more expensive. I find it hard to believe that people will go our of their way to preserve their health in order to save the taxpayer money. This is especially true when they won’t do it to save themselves or their children future risk and suffering. Regards, Shodan ---
**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, 8:51pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/74 "2009-01-27T20:51:54Z")
> [@Really\_Not\_All\_That\_Bright](#): > > You know homicide statistics include justifiable homicides, including police shootings, right? No, I didn’t know that. Are you claiming that the murder rates in the United States are roughly the same as those in the UK and the US figures look higher because justifiable homicides are included? > [@](#): > > What exactly will this prove? That northern England is not full of underclass types in the same way that parts of the US are. ---
**Author:** ![kidchameleon](https://avatars.discourse-cdn.com/v4/letter/k/898d66/32.png) [@kidchameleon](https://boards.straightdope.com/u/kidchameleon)\ **Post date:** [January 27, 2009, 8:55pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/75 "2009-01-27T20:55:53Z")
> [@Capt.Ridley\_s\_Shooting\_Party](#): > > Britain and the US have comparable violent crime rates. Soccer hooliganism is orders of magnitude higher in the UK. 😉 > [@LavenderBlue](#): > > 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. We also eat like crap and have less healthy lifestyles. ---
**Author:** ![Tuckerfan](https://avatars.discourse-cdn.com/v4/letter/t/eada6e/32.png) [@Tuckerfan](https://boards.straightdope.com/u/Tuckerfan)\ **Post date:** [January 27, 2009, 9:09pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/76 "2009-01-27T21:09:02Z")
> [@Shodan](#): > > Doesn’t the underclass already get taxpayer-funded health care, thru Medicaid? It is nowhere near universal amongst the underclass, however. Generally, the _only_ way you can get it is if you’re on disability, pregnant, a mother with children, or a child. There _are_ exceptions to this, of course, but they vary from state-to-state, and year-to-year (sometimes). Just being poor does **not** guarantee Medicaid. ---
**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, 9:12pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/77 "2009-01-27T21:12:37Z")
> [@brazil84](#): > > I’m not sure what you mean by “suggested South Africa as a model.” If somebody wants to claim that Canada is comparable to the United States, it’s hardly outrageous, in turn, to compare the United States with South Africa. South Africa has nearly ten times the violent crime rate that America has (how well the rate actually reflects the truth is anybody’s guess). Further, America’s the world’s richest nation with a well developed infrastructure, and heavily industrialized, whereas South Africa as a rule, isn’t. America and Canada have similar levels of industrialization and have much more similar crime rates than America and South Africa. So yes, suggesting South Africa is outrageous. Further, as noted, this whole discussion is begging the question. Why does violent crime rate matter? The aftermath of violent crime is already handled by your ramshackle version of socialist medicine anyway. ---
**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, 9:14pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/78 "2009-01-27T21:14:21Z")
> [@brazil84](#): > > That northern England is not full of underclass types in the same way that parts of the US are. It isn’t, that’s true. But, the whole “underclass” crap is just a diversionary tactic to allow you to put the boot in on the blacks, again, so it’s irrelevant. ---
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [January 27, 2009, 9:15pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/79 "2009-01-27T21:15:49Z")
> [@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. You don’t think we have welfare bums? Wow, you didn’t see much of Canada. ---
**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, 9:20pm UTC](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193/80 "2009-01-27T21:20:50Z")
> [@kidchameleon](#): > > We also eat like crap and have less healthy lifestyles. Cite? Are American eating habits really that bad compared to the rest of the world? **Shodan** , I am looking for a cite. But I would daresay most of the present vaccine refusal does not come from those who are on medicaid and refuse to do the right thing and protect their kids against measles. It comes from many upper middle class parents who read the anti-vax forums at Mothering and put their brain cells on hiatus. They listen to the next door neighbor who swears her son was fine until one day he got TEH EVIL VACCINE from the pHARM company and was broken forever!!! They take Jenny McCarthy seriously. That really has nothing to do with NHC. [Previous page](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193.md?page=3) [Next page](https://boards.straightdope.com/t/usa-really-too-different-from-english-speaking-world-to-have-similar-policies/483193.md?page=5)