What I'd like to see if universal healthcare is implemented

Great Debates
1

Triple or quadruple tobacco taxes. If I’m paying for your emphysema or cancer treatment for something you’re doing to yourself by choice, you should help in a disproportionate way. Also stricter regulation of what’s in those things. If it’s true that they contain additives that make them more addicting, then that needs to stop.

P.E. class every single day, all 13 years of public school. None of this recess when you have time in elementary school, P.E. once or twice a week in middle school, and half a year of P.E. in high school. Exercise needs to be made a priority and a part of American lifestyle. If I’m paying for your diabetes meds or treatment for your heart attack at age 40, I don’t want it to be because you never even tried working out.

ALL fast food, vending machines, and soda out of public schools, and a complete revamp of what is served in cafeterias. No more pizza, french fries, mashed potatoes, and sweet tea 5 days a week. People should be taught that junk food is an indulgence that shouldn’t be taken at every opportunity (which in our society is every time you want to eat, as of now.)

More education about things like trans fats, and more honest and prominent labeling of them. As of now, anything that says “0g Trans Fat!” is virtually guaranteed to contain trans fat. Loophole labeling like this needs to stop.

I’d like to see some reform in the national dietary guidelines. I’ve read from what I believe are some credible sources that the prevailing standards accepted by the FDA/AMA/NAS are based on archaic ideas like all fats being bad, all cholesterol being bad, most or all carbohydrates being good, etc.

I’d like to see the decimation of pharmaceutical lobbying and sales. You can’t even talk to a doctor anymore because they’re too eager to shove pills down your throat. The last few times I’ve seen a doctor I literally haven’t been able to finish telling them what’s wrong because they stop me, write a script, and walk out. It wasn’t like this even 10 years ago, and from what I hear it’s still not like this in a lot of other countries.

No more seeing an MD for boner and allergy pills. You really should see someone more like a nurse or even a pharmacist for this kind of stuff.

No more advertising perscription drugs. I can’t believe they allow this.
It’s not that I don’t want to help my fellow man out with access to medical care - I do - but the world’s fattest (or 2nd fattest, depending on who you ask) nation needs to look inward a bit before we start paying for everybody to wish their ails away in a doctor’s office. A disturbing amount of our diabetes, heart disease, and cancer is preventable. Or delayable by years or decades, at least.

I’m dreaming, I know. Most of these issues aren’t even up for debate because there’s too much money up for grabs out there.

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Ponies for all!

3

The problem is that tobacco taxes are really already very high. Tax it higher and pretty soon you’re going to see bootleg untaxed cigarettes on streetcorners. The last thing we need is a black market in tobacco.

4

I think it’s far more practical than “hyuck hyuck, ah wants summadat free heawfcare.” But unfortunately a lot of people tune out when you tell them that eating fast food and drinking soda every day, and never exercising may be why they feel like shit and have to shoot up insulin. Or why they’re already wearing nitro around their neck in their 40s. And of course Americans want their god-given “freedom” to suck down a pack of Marlboro’s every day, though this one confuses me because I was never less free in my life than when I was addicted to cigarettes.

“Western medicine” as the loonies like to call it is great at treating things like cancer, broken bones, apendicitis, etc, but frankly it’s awful when it comes to overall wellness. They’d rather put you on diabetes medication than tell you to start dieting and exercising (even though they know damn well the latter would work better and cost nothing), for fear of offending both you and the pharmaceutical companies.

It sucks and I don’t think wishing for some reform is equivalent to asking for a pony. Quite the opposite, really. Thinking the status quo is working is more like pony-wishing.

5

The problem of minimizing the financial incentives for people to take responsibility for their own health is a pretty significant problem for UHC. And I think if you want UHC, you just have to bite the bullet and accept that you’ll be paying for the health care of people who take unnecessary risks with their health. The only comfort being that you’re already doing so.

You could go the direction you suggest, using UHC to justify all manner of restrictive government regulations, but I’m afraid that’s exactly the bogeyman that will be successfully used against UHC. A better proposal might be to simply exclude a bunch of people from the public plan (smokers, motorcyclists, junk food enthusiasts, etc.), but then you’re probably just back to something pretty close to the same inefficient, unfair system we have now with maybe a few more million people getting subsidized coverage.

So I think UHC-supporters just have to bite the bullet of paying for risk-takers if they want UHC to pass.

6

I have no problem with this because smoking is voluntary and medically has no positives, only negatives. If we went UHC it would seem perfectly reasonable to me.

Do you have research saying that it would actually result in fewer people with diabetes and heart attacks? For those who exercised only because they had to, if they stop exercising after high school it would seem to me that 18 years of forced exercise vs 22 years of not exercising probably wouldn’t have that much of an impact of preventing the onset of diabetes or a heart attack at 40. But since this is my gut feeling and not based on research, I could be totally wrong.

So what would you have served instead? I hope that didn’t sound snarky because I’m genuinely curious.

Agree and agree.

I don’t know. How many people actually pay attention to those things? Also, nobody can agree on what’s good for you and what isn’t. The food pyramid has changed over the years and certain foods that are being blasted as being bad for you will, in a few years, be promoted as being healthy, then a few years later will be bad for you again. Why experts can’t agree, who knows.

My experience has been the opposite, but I don’t what the general experience of the US public is on this. If it turns out that most doctors are just prescription vending machines, then yes, this should be changed.

Sounds good to me.

I think you would run into freedom of speech issues if you tried to have it banned. Although it might be a good thing if the pharmaceutical companies voluntarily stopped and it caused a drop in drug prices.

True

There’s going to be change, one way or another, it’s just a matter of time. Although you are probably correct in that it will focus mostly on the insurance and pharmaceutical companies and very little on the role that health-care consumers play.

7

Heck, I’m reasonably happy with the status quo.
Wait a tick, I live in Canada. We get free health care and ponies, though when the winters are especially cold, we have to eat them.

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Comments like those in the OP are one of the biggest reasons that type of reform won’t happen. It is an interesting experiment to see how many different types of people you can piss off at the same time though and force them to rally together.

My suggestions are pretty simple. I would have many more locally based clinics staffed primarily by nurse practitioners and and other types of nurses rather than M.D.'s They wouldn’t have huge rooms full of expensive equipment but they could provide primary care for routine and non-critical problems. These already exist in some places but there needs to be a lot more. Waiting in the emergency room of a major hospital for 5 hours to treat a broken toe or pull a crayon out of a child’s nose is ridiculous for everyone involved. Of course, these clinics would be allied with the nearest full hospital for emergencies.

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The idea is to make exercise a part of people’s daily life growing up, so it doesn’t seem so weird to go for a jog or shoot some hoops when you’re 35. Exercise tends to begat more exercise. Some kids would angrily fight it tooth and nail every year, but the average would rise significantly, I think.

Edit: (Anecdotally, from the many Indians I know) In India, they do yoga in school every day. Most Indians continue this for the rest of their lives. I can only speculate that the rate of people doing it after their school years would plummet if they quit doing it in schools.

Water, milk, whole grain breads and tortillas, beef and chicken (and fish if it makes financial sense), vegetables, fruit. You know, food. As opposed to Taco Bell, Pepsi Cola, and IFH frozen pizza.

Schools and doctors pay attention to them, and some individuals do, too. And our knowledge of what’s good for you and what isn’t has never been better.

It was banned until a few years ago, so it’s definitely not a constitutional thing.

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Which comments, specifically, are you referring to?

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All of them except for the point about boner and allergy pills. The rest of them will meet with some stiff opposition not just from consumers but also lobbying groups. Greatly raising tobacco taxes is plenty bold enough (if not suicidal) but you also seem to want to take on the pharmaceutical industry, the American Medical Association, food manufacturers, the FDA and even the PTA at the same time. That takes guts my friend.

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I like it.

What you seem to be doing with your approach is adding to the supply-side of the equation at lower additional cost, by relaxing requirements on licensing to practice certain procedures.

Why not just go the whole way and make licensing voluntary, rather than enforced by the government?

If someone wants to be treated by a professional with ‘AMA approved M.D.’ after their name, that is their choice. If someone wants a crayon pulled out of their nose by a local mechanic who hangs out a shingle with ‘Crayon Pulling Out of Noses - $1’ that would be their choice too.

That way, a whole bunch of lower-cost supply can be added to the system and patients will have more choice.

13

High school needs almost as much of an overhaul as health care. Instead of getting students to memorize trivia like who won the Crimean War, teens should be taught necessary functional skills like how to manage money and take care of their health.

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Good idea. And lots of these exist already. Free-standing 24 hour emergency care clinics are reasonably popular. But they don’t seem to have made a dent in the problem, since they usually migrate to areas where they can make money easily, in other words suburbia.

15

So, why is it that countries with UHC also have a lower obesity rate than then major country without it?
Universal care, alas, does not cut costs. We need to do other things, and the list in the OP seems a reasonable start.

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Because the marginal effect of the provision of universal care on risk-taking behavior is a drop in the bucket compared to the other factors that cause obesity.

In any case, it isn’t even necessary to my argument that UHC eliminates financial incentives to be healthy. That is one consequence of some plans (not necessarily what’s being proposed), to be sure. But what I’m primarily saying is that under UHC, you have to pay for people’s risk-taking behavior. That’s the bullet you bite.

Frankly, I think analyzing health care as one more market good is foolhardy. With respect, IdahoMauleMan’s post reads like a reductio ad absurdum to me. I think patients make terrible consumers, because of information and power differentials. And I think commodifying health as if it were interchangeable with choices about what car to drive or what TV to own is naive. So I’m all for shifting the balance in our hybrid system a bit further away from market control. I just recognize that this comes with the unfortunate cost of paying for the risk-taking behavior of others. And I think that shutting down people’s liberties because it costs us too much to take care of them is not the right answer to that problem.

17

correlation does not equal causation?

So if USA implements UHC, it will reduce obesity?!?!? What are you smoking?

How does UHC encourage a middle-aged slouch to get his fat ass off the couch, throw out the greasy potato chips he’s been munching on, stop watching TV, go outside and shoot some hoops or jog around the neighborhood?

Unless you’re saying UHC would include liposuction as part of the benefits package. Do European countries pay for liposuction for all their citizens? No wonder Americans want it!

18

Heh, I think you overlooked an even better way of attacking this issue. The point isn’t to tax things that you already were predisposed against, especially lower-class pathologies that people dislike anyway. The trick is to find unhealthy things to tax that liberals like.

Bacon taxes. 200-300% bacon taxes. Under UHC, heart attacks drive up my tax bill, and this negative externality should be redressed with a tax.

Speed limits need to be lowered further, and enforced. Accident treatments, except when the people die immediately, are expensive.

Heavier law enforcement efforts against illegal drugs, and stricter penalties for people who use them. You have no idea how many ER visits are due to drug overdoses, and that’s coming out of my wallet.

Loud concerts also need to be taxed. Can’t ban them - that’s free speech - but we should address the externalities of treatment for long-term hearing loss.

(this one is reaching) Organic food has a higher case of contaimination and parasite load, which costs money to treat. Organic food should be taxed.

Any more takers?

19

I think the OP is right on.

20

SPEED LIMIT 45 mph
(OR >120 mph)

:smiley: