I never said health care was driving it (Although truth be told it is one factor. The amount of money that employees have had to contribute to their health care plans through deductibles and co-pays is through the roof over the last decade.) . In response to your post that the middle class is struggling, I pointed out that middle class salaries have been flat (which a quick googling will reveal to be true) as the one of the primary reasons why.
Rising gas prices (relative to inflation) are a piece of the fallout from the Bush administration. Remember how gas was $1/gal. in 1998? It was actually cheaper in the 90s, correcting for inflation, than it was prior to the 70s oil crises.
Anyway, receiving a raise does not necessarily mean your salary did not stay flat. You could quite easily receive a “raise” that doesn’t even meet the standard of a cost of living adjustment.
We don’t “add to the tax burden” at all. There hasn’t been a tax hike since Bush I. Instead, we just borrow more money. If you’re pissy about the national debt, I can sympathise with that. I anxiously await your pitting of the Republican Party.
Jeez, I worry about stepping into the nastiness here but do have a question. In general, I don’t favor UHC because I beleive it would be less efficient. I also believe it’d cost me more, but the cost argument in this thread has degenerated to name calling and whining at this point, and I’m not interested in going there with you folks.
The dollars worry me, but the efficiency question is even more worrisome. In terms of relative population (Canada at 33 million, UK at 60 million, Germany at 82 million) we’re talking about creating a bureaucracy that will be 10 times larger than the UK, and more than three times larger than Germany. How can that possibly be more efficient? Heck the DMV in my state can’t get me in and out in less than three hours, and my state only has 7 million people in it, many of whom don’t drive. Other government bureaucracies are the same. Indeed, I can honestly say that I can’t name a single government entity that does its job well and with an eye toward keeping expenses down.
Frankly, I don’t have any faith in a governmental organization to effectively and efficiently manage a national healthcare system. What is the argument that it can?
I think you mean 10 times larger than Canada, not the UK…
Also, for the record, the USPS manages to turn a profit nearly every year.
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The government already effectively and efficiently manages a national healthcare system. Medicare/Medicaid and TriCare (the health insurance program which covers members of the military and their families) cover approximately 30% of the population already. Most inefficiency there is due to the fact that M & M have to determine whether they are the primary payor for every single claim, since many people are covered by private insurance supplements as well.
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The DMV in your state is operated by your state. If your state bureaucracies are poorly run- and many are- that doesn’t reflect on the management ability of the Federal Government.*
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I don’t think you realize just how much inefficiency is inherent in the current system. Every health insurer uses its own data management systems, its own data transfer systems, and its own approval/pre-approval procedures. There is an entire multi-billion dollar industry built around managing health insurance programs for employers which utilize more than one health insurance provider for their employees- as most employers which operate in multiple states have to.
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In addition to having to deal with the policies and procedures of a thousand health insurers, the current system has to allow for the massively varying statutes, codes and case law of 50 states. While management of the nation’s health insurance on a national level by the government may not be much more efficient, it certainly won’t be any less efficient.
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Two entire layers of the existing bureaucracy will be removed automatically. Private health insurers have to ensure that, a) you/your employer pay your premiums, and b) that you are covered, when you file a claim. Under UHC, only your provider would have to ensure that you’re covered, which they have to do already anyway.
*This, of course, assumes that a hypothetical national health insurance plan is administered by the Fed, and not devolved to the states. In that case, the system will probably suck balls.
At present, every state has 50 different rules and regulations regarding health insurance, which means insurance companies all have to have people to handle each state’s regulations. If the insurance company wants to make a change to its policies, it has to check with every state to see if that will be in compliance with the various laws. It gets to be a real hassle for corporations who have employees in different states, as what is legal in one state, may not be legal in another.
Each insurance company has its own preferred form of paperwork, that doctors and hospitals must comply with, if they want to accept a patient covered by that insurance. UHC creates a national standard of care, and the same standard of paperwork. That alone, is a huge savings.
As I pointed out earlier, its a big headache for the car companies to deal with multiple environmental regulations (and is why they’re so opposed to CA having their own emission standards, even though CA is the largest single market in the US). Folks who’ve dealt with other environmental regulations (say powerplants) have stated that their biggest headaches come from dealing with all the various state regulations, as well as the Federal regulations.
Having a single payer system, along with a more standardized system of records would also cut down on things like “doctor shopping” where someone goes to different doctors to get prescriptions for pain killers to either feed their addiction or sell on the street.
Finally, if you’ve got a problem with the DMV, then you do have recourse to correct this: Your elected officials. Bug the crap out of them until they do something about it.
I can’t speak for liberals so well, I’m a social democrat. But I’ve certainly seen excessive optimism on the right as well as the left. The right-wing faith in the wonderful magic of tax cuts is generally let down by facts. So that’s not a purely lefty problem.
That said, I certainly didn’t say that the problem with the money spent on Kansas City schools was tactical. I said it was offensive to use state taxes on one city while neglecting the rest of the state. Which it was. And that wasn’t a liberal program from the legislature, that was one rogue judge.
I agree. W/ both sentences. I would add that there will be a lot of stupidity, waste, mismanagement, manipulation by special interests, and so on in any public policy–including policies of privatization; or a half-private system such as is common in the USA, with restraint of trade on one hand & a default to market economics on the other.
Anyone willing to advocate opening more medical schools to train more doctors, with or without the assent of the AMA, has my support. And if it uses a theory of free competition, fine. Maybe the free market can work if we open up the supply side as well as the demand side.
RNATB - You’re right, I meant Canada.
The DMV was a bad example - so I’ll pick a massively inefficient and poorly run department instead - the USCIS. The best data I can find (sorry, it’s a Wiki but I’m busy at work today) indicates that the USCIS handles about 1 million immigrant applications a year. From personal experience I can tell you that this is a ridiculously inefficient department. I can’t imagine how poor thier services would become if that number was twice higher, much less 300 times.
The fact that the USCIS is the only agency handling immigration applications means that all of the paperwork comes under “national standard” for immigration paperwork. There are also no state regulations that govern the approval or denial of immigrant applications. That hasn’t stopped that agency from becoming a shining example of uselessness. Since 2002 we’ve spent $1 billion to make it more efficient, with no result. If this government agency cannot manage transactions with a mere 1 million people a year, how will another government agency handle transactions for 300 million people a year?
If part of the inefficiency of today’s system is the varying paperwork and laws why not address that issue first, then see where we stand? I know that’s not going to help the uninsured right now, but if the savings that a standard would purportedly create could be realized, could those savings be used to extend Medicare/Medicaid? If not, is it because the savings not offset the costs, or for some other reason?
My gut feeling is that it’s just too big to be done right, and your question of how much the states will be involved only makes the propect scarier. I’d have to agree with you there: it would suck balls. I will grant that my gut feeling probably has a lot to do with my interactions with both USCIS and the VA, but I don’t think that makes my concerns any less real.
Tuckerfan: I’m pretty sure I’m on a “watch out for this nutjob” list somewhere, given the amount of time I spend bitching to politicians. 
And thanks to both you and RNATB for the reasoned responses. I’m genuinely curious, and will readily admit I haven’t spent nearly the amount of time looking at the UHC proposals as I should have.
I also have lots of personal experience with USCIS/INS - I’m British, and a green card holder - and yes, it sucks. However, there are a few factors you’re missing here.
- USCIS doesn’t have to be efficient. People want to get in? They can wait. I can tell you from my mother’s personal experience that the UK Home Office’s Border Agency (which was called something else back in the day, I’m pretty sure) is equally inefficient, though generally staffed by people with more common sense.
Anyway, the point is that USCIS is the one government agency which can most afford to be a mess because voters don’t have to deal with it.
Also, most of that money wasn’t spent on making it more efficient in terms of processing paperwork and getting your passport renewed faster and so on. It was spent on making USCIS better at catching crooks. Everything spent since 2001 has been spent on antiterrorism stuff, it seems- or at least on stuff which is claimed to be for combating terrorism.
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The paperwork may be standardized, but it has to be published in 200 different languages, and every office needs people who speak lots of languages, from data entry personnel to officials. Of course, finding a US citizen who speaks Gaelic or Swahili or Haitian Creole and who wants to work in a government office in New Mexico is not easy.
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Most healthcare claims approvals procedures can be computerized. You only need people to review the ones which are appealed, or the ones which are unusual - “medically necessary” breast implants, and so on. Immigration/asylum/visa applications usually can’t be computerized; the computer isn’t going to know whether your marriage is legit or a green card scam, etc.
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I think you meant “for us to spend our money”, right?
In a system where most people get a better deal from their union’s purchase or their employer’s purchase than they could get alone, there’s no real accountability to individual clients.
Except that I am aware of what a cost of living adjustment is, and our raises have always been more than that.
I pit both parties.
Simply because there hasn’t been a national tax hike doesn’t mean there haven’t been taxes hiked and added locally and state wide. And, as I’ve said, I do not believe that the government can install a UHC without creating a tax for it.
Add to that the facts of the messes that are Medicare and Medicaid, and - yeah, what he said.
No, all I am concerned about is my money. You may spend yours any way you wish, such as giving it to the government to waste.
I’ll put this in simpler terms: what difference does it make to you whether you give your money to a wasteful private health insurer with a profit motive or a wasteful government with no profit motive?
The former won’t waste it on some lazy ass’s care.
Because I believe that it would be far less of my money wasted with the private insurer. The US government has not proven that it can efficiently run a national health care program.
As opposes to the current players, who have proved that they can’t.
Curlcoat: If UHC was accompanied by a large increase of tax rates for the rich, would you be okay with it?
I’ve tried to read all of this thread (though I admit to skimming over some of the Objectivism when it became too Objectionable for an ethical human to bear) and I haven’t seen it posted yet so I’ll just remind folks:
"Universal Health Care is a great idea in reality, but it’ll never work in theory."
Apologies if I got the wording wrong or if it’s already been posted, and full credit and props to the originator of this hilariously clever, yet quite accurate comment. I believe it was Brain Glutton.
Since I live in the real world, the answer would be no since I cannot see that there would be an increase of taxes on the rich without there also being an increase on the middle class.
I just don’t get this belief that the rich (ie anyone with leftover money) should be financing the poor, just because they are poor. For example here is a story on people upset that a couple of poor kids in India were not given “enough” for their part in a movie. Note that these two kids worked for a month, were paid $1000 and $2400 in a country where most of the people live on less than $2 a day AND paid for their schooling, as well as the start (or all of, not clear) a college education.
It’s just never enough. Simply because the makers of the movie are viewed as rich, for some reason they are “supposed to” give even more to a couple of kids that their parents brought into this slum they are living in. Now because they think that they have a way to blackmail the movie makers, suddenly this slum isn’t good enough for their kids, or themselves. The windfall of cash and the paid schooling just isn’t good enough.
I know India isn’t the best example, but it’s just the latest and it’s certainly not like this sort of thing doesn’t happen over here.