# What should "national health care" be in the USA? **URL:** \ **Category:** Great Debates\ **Created:** [November 8, 2003, 6:36am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049 "2003-11-08T06:36:48Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [November 9, 2003, 3:03am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/41 "2003-11-09T03:03:44Z")
The uninsured are such a bore. We should just be allowed to eat them. ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 3:36am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/42 "2003-11-09T03:36:55Z")
> [@](#): > > \*Originally posted by ‘possum stalker \* > \*\*As I said before, the answer to your last question is “enlightened self-interest.” If society has doomed me to die because I’m uninsured, what interest do I have in society? What’s to stop me from pullin’ a “John Q” (remember that stinker?), or join the freakin’ Taliban? I have always wanted to say this: that attitude is why America is going to hell in a handbasket. What are you trying to do, bring back Communism?! \*\* Actually I don’t remeber who you are refering to as “John Q”. But if I take you other references correctly you are saying that unless I help to pay for your medical costs you will make war on the united states? So it is in my self interest to give in to your extortion by letting the government take my money and pay for your health care? I’m not at all sure what you mean by “self interest”. I suspect that you are using the term “enlightened” to completely pervert the meaning of self. I have not always wanted to say this, but I have suspected it for some time. “That attitude is why America is going to hell in a handbasket.” And what do you mean _“bring back”_ communism? When were we ever communist? Also, I have to ask, what exactly do you think communism means? IF nationalized health care is not a hop skip and a jump _towards_ communism I don’t know what is. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [November 9, 2003, 4:09am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/43 "2003-11-09T04:09:20Z")
**pkbites** , I was one of your “scumbags” who was unfortunate to have lived without health insurance for a few years. I don’t think that calling people less fortunate than you “scumbags” is a good way to start off a debate. So don’t go around claiming moral highground that you don’t own. > [@](#): > > We can’t all have the same. No, but we can make sure that everyone has something. This is not communism or liberalism. It’s decency. ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 4:09am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/44 "2003-11-09T04:09:41Z")
> [@](#): > > _Originally posted by BrainGlutton \* > \*\* I’ve never met a Canadian who had anything really bad to say about it._\* I realize this is a less than ringing endorsement of the Canadian health care system. So I found a link that was overall positive about it, but had a few good gems in it. [First the link](http://www.hc-sc.gc.ca/english/care/romanow/hcc0094.html) Now the gems: > [@](#): > > There is little doubt that Canadians believe the health care system has deteriorated over the past decade. In 1991, 61 per cent of Canadians thought the system was excellent or very good (and an additional 25 per cent thought it was “good”). In 2000, only 29 per cent shared that strong view (with an additional 34 per cent saying it was “good”). > > Topping the list of Canadians’ concerns about the health care system are waiting times, a lack of the most sophisticated equipment, a shortage of specialists and shrinking staffs. > > A large number of surveys have shown that while the vast majority of Canadians continue to be satisfied with the health care they have received, the number who express concerns have jumped dramatically. Between 1989 and 2000, the number who said they were unable to access needed health care services soared from two to 15 per cent, and the number who said they and their family have had difficulty accessing needed health care services almost doubled, from 18 to 34 per cent. > > … > > Most Canadians, however, would prefer to improve the quality of the health care system without raising taxes, privatizing key elements of the system or cutting spending on other key spending priorities. > > … > > Yet, the report also found that most people are “sensitive to the desire among many Canadians to spend their own money if they are facing a lengthy wait for treatment.” When asked if people should be allowed to have the option of using private health facilities, with their own resources, if they cannot get timely access to the public health care system, 73 per cent of respondents responded affirmatively. > > … > > 20 per cent of Canadians who used the system in the last year said the quality of care was “fair” or “poor”. A full 78 per cent said that their experience with the system was positive. Almost one in four (23 per cent) said they are not confident that they could receive the care they needed if they became ill. I have found a few rumours about Canadians coming to America for needed medical treatement. Conservative like to claim that they are coming accross the border in waves for operations. Liberals seem to think that it is only 1 or 2 people. Do any of you have access to real statistics? ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 4:32am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/45 "2003-11-09T04:32:10Z")
> [@](#): > > \*Originally posted by monstro \* > \*\ ***pkbites** , I was one of your “scumbags” who was unfortunate to have lived without health insurance for a few years. \*\* OK, he is not addressing this, so I will. I certainly don’t want to speak for you, pkbites, so I appologize if I put words into your mouth. HE NEVER SAID THAT! Sorry, I had to get that off my chest. He never said or in any way indicated that someone without health insurance is a scumbag. He merely acknowledged that the world contains scumbags and decried the necessity of paying for them. ---
**Author:** ![Gorsnak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gorsnak/32/7587_2.png) [@Gorsnak](https://boards.straightdope.com/u/Gorsnak)\ **Post date:** [November 9, 2003, 5:13am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/46 "2003-11-09T05:13:16Z")
> [@](#): > > \*Originally posted by pervert \* > As to your second question, you missed the point altogether. I preffer the **I** make my health care decisions. I want to choose which insurer I use. I want to choose which doctor I see. And I want to have the final say on which procedures are performed. If I need a procedure that I cannot afford I will certainly not be knocking on your door to steal the money for it. All I ask in return is that you extend me the same regard. On the contrary, I didn’t miss your point at all. _You_ missed _my_ point. I quite realize you would prefer to make your health care decisions yourself (with your doctor’s advice, presumably). I feel the same way myself. However, in my experience (and I’ve lived under both systems, and having ulcerative colitis used both systems on a somewhat routine basis) my ability to make my own decisions was far more limited in the US under a quite good insurance package than it ever has been in Canada - frankly I can’t think of a single time I’ve ever felt a decision has been made for me, nor have I ever personally encountered a waiting list, not that I’m trying to cast doubt on their existence. So, like it or not, your decisions are made for you by insurance co bean counters to a far greater degree than my decisions are made for me by bureaucrats. And even if the degree of interference were the same, I’d rather the bureaucrat interfere than the bean counter, for reasons I’ve expressed in previous posts. Anyways. I did quite like your first snippets about the Canadian health care system. I found them to be quite typical of the exaggerations usually made by those ideologically opposed to universal public health care. Your last post is actually quite accurate. There have been growing problems, dating back not coincidentally to the point in time when Paul Martin started axing federal funding of everything under the sun, including health care. The system is currently cash-starved, which is the source of the waiting lists, etc, and this problem certainly needs to be addressed. However, it’s not remotely clear that large-scale privatization would help, and even modest re-funding of the system would likely do the trick. For my money, the Romanow report was pretty much bang on in its conclusions. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [November 9, 2003, 5:15am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/47 "2003-11-09T05:15:25Z")
> [@](#): > > He never said or in any way indicated that someone without health insurance is a scumbag. He merely acknowledged that the world contains scumbags and decried the necessity of paying for them. He didn’t mention the problems of normal, everday, hardworking people without health insurance. No, he set up a dichotomy in which there are two groups of people: those who’s hard work has earned them with health insurance and then the thieves, scumbags, failures, and losers without it. He even beat us over the head with the fact that his even 18-year-old has it. Implicit is that there’s something wrong with us if we don’t have health insurance. I think anyone who does not have health insurance has the right to be offended by his post(s). > [@](#): > > And how do you justify parasites receiving benefits from a system they don’t to contribute to? Just to clarify, **pkbites** , how would you feel about a program that guaranteed insurance for everyone who is employed? If it’s just the parasites that worry you, then you shouldn’t have a problem with something like this. ---
**Author:** ![\_possum\_stalker](https://avatars.discourse-cdn.com/v4/letter/_/b77776/32.png) [@\_possum\_stalker](https://boards.straightdope.com/u/_possum_stalker)\ **Post date:** [November 9, 2003, 5:26am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/48 "2003-11-09T05:26:47Z")
**Perv** - I never advocated making war on America. I was just using some crappy, overwrought examples rather in keeping with the OP. Some of the last bit was even sarcasm. I also believe people from Wisconsin should be allowed to drive on roads in Illinois. If you were wondering. ---
**Author:** ![pkbites](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pkbites/32/204_2.png) [@pkbites](https://boards.straightdope.com/u/pkbites)\ **Post date:** [November 9, 2003, 5:56am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/49 "2003-11-09T05:56:37Z")
> [@](#): > > \*Originally posted by monstro \* > **Just to clarify, pkbites, how would you feel about a program that guaranteed insurance for everyone who is employed?** And who has to pay for this? Tax dollars? Forget it.And who would be providing the coverage? Would you mandate that insurance companies HAD to? Regardless of risk? Would you also force insurance companies to sell auto policies to bad drivers? My message is not “whoever doesn’t have insurance is a scumbag”. That’s ridiculous! My message is, medical care/insurance is an individual responsibility. Buy a policy, make out a deal with your employer, change jobs to one with bennys, join a union shop, intentionally choose to go without, whatever. But don’t insist that everyone elses tax dollars pay for it. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [November 9, 2003, 6:10am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/50 "2003-11-09T06:10:35Z")
> [@](#): > > Buy a policy, make out a deal with your employer, change jobs to one with bennys, join a union shop, intentionally choose to go without, whatever. Like it’s so easy. I hope you never fall on hard times, and know what it’s like NOT to have a job, and NOT to have insurance. Try getting laid off because your boss is a crook right after buying a house while having a wife and two kids to support. For almost a year. And then come back here and say “Oh, well, he should just get a job!” That was my dad. Some people aren’t that lucky, you know. Not everyone is as fortunate as you. Maybe you should go and do some research and see what it’s like NOT to have, and to work your ass off and STILL not have. Because that’s reality. And I resent the HELL out of people who imply otherwise! ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 6:22am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/51 "2003-11-09T06:22:27Z")
> [@](#): > > \*Originally posted by Gorsnak \* > \*\*in my experience (and I’ve lived under both systems, and having ulcerative colitis used both systems on a somewhat routine basis) my ability to make my own decisions was far more limited in the US under a quite good insurance package than it ever has been in Canada - frankly I can’t think of a single time I’ve ever felt a decision has been made for me, nor have I ever personally encountered a waiting list, not that I’m trying to cast doubt on their existence. > > … > > So, like it or not, your decisions are made for you by insurance co bean counters to a far greater degree than my decisions are made for me by bureaucrats. > > … > > And even if the degree of interference were the same, I’d rather the bureaucrat interfere than the bean counter, for reasons I’ve expressed in previous posts.\*\* Well, your first part is your experience. I have not reason to cast doubt on it. And I most certainly respect your right to express it. However, the second part is your attempt to apply your experience to mine. I have never once felt that I had any decision made for me by any insurance carrier. And even if they tried, I believe I can hire another carrier or pay directly for the service myself. A choice which is illegal in Canada. Your third part still mystifies me. Unless I missed it, your previous posts simply said that you believe the bureaucrats have your interests in mind more than the bean counters. I don’t understand this attitude at all. Remember, the bureaucrats are simply bean counters with the ability to use the powers of the state to implement any of his ideas. When the government hires a bean counter what exactly do they do to enable him to be more interested in your needs? ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 6:24am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/52 "2003-11-09T06:24:27Z")
> [@](#): > > \*Originally posted by 'possum stalker \* > \*\ ***Perv** - I never advocated making war on America. I was just using some crappy, overwrought examples rather in keeping with the OP. Some of the last bit was even sarcasm. > > I also believe people from Wisconsin should be allowed to drive on roads in Illinois. If you were wondering. \*\* ---
**Author:** ![davidm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/davidm/32/225_2.png) [@davidm](https://boards.straightdope.com/u/davidm)\ **Post date:** [November 9, 2003, 6:24am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/53 "2003-11-09T06:24:39Z")
> [@](#): > > \*Originally posted by BrotherCadfael \* > \*\*But hospitals in Vermont and other northern tier states are full of Canadians who wanted procedures either unavailable or on a HUGE waiting list back home… \*\* **Full** of Canadians? **Huge** waiting lists? Do you have a cite for this? Here’re two cites that seem to indicate that claims of huge waiting lists and large numbers of people going to the US for treatment are at the very least overblown if not simply untrue. [Phantoms In The Snow:Canadians’ Use Of Health Care Services In The United States](http://www.healthaffairs.org/freecontent/v21n3/s6.pdf) [For-Profit Health Care: Dispelling the Myths](http://www.chac.ca/public/fact_sheets/sheet1.pdf) An interesting thought from the second link: > [@](#): > > For all the criticism of Canada’s medicare program, I for one would be delighted to have its manageable problems in place of those in the United States. > > Theodore Marmor > Yale School of Management ---
**Author:** ![Gorsnak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gorsnak/32/7587_2.png) [@Gorsnak](https://boards.straightdope.com/u/Gorsnak)\ **Post date:** [November 9, 2003, 6:27am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/54 "2003-11-09T06:27:10Z")
It has to do with incentive structure, as I’ve already said multiple times. You honestly think that insurance companies don’t care more about the bottom line than governments do? Colour me baffled. Personally, I’d rather the hypothetical person making these decisions be more worried about how I’m going to vote next election than how to minimize the amount of money I’m costing to provide care for. ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 6:48am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/55 "2003-11-09T06:48:00Z")
But what makes you think the bureaucrat does not care about costs? You said yourself that the system is cash strapped. Does this not mean that it has less money than it needs? Did you not suggest yourself that this may be what is causing the waiting lists? Remember, I have several remedys against the bean counter. I can hire someone elseor sue him for instance. If we examine the statistics from my earlier post, it becomes obvious that Canda is not likely to drop the 1 tier health care system soon. So what exactly does the bureaucrat have to fear from your vote? Do you really think that the next president can fire anyone he wants for any reason? I expect (I could be wrong) that firing a bureaucrat can be very difficult. Especially if all he did was apply the letter of the law to the best of his ability. Remember, if I don’t like the policy of my insurance carrier, I can change carriers. If you don’t like the policy of your bureaucrat, your are screwed. ---
**Author:** ![pervert](https://avatars.discourse-cdn.com/v4/letter/p/bbe5ce/32.png) [@pervert](https://boards.straightdope.com/u/pervert)\ **Post date:** [November 9, 2003, 6:52am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/56 "2003-11-09T06:52:01Z")
davidm, thank you for the links. However, I think they are no less biased than those I posted. I think both sets of links are skewed towards probin a point rather than providing the true information. I especially liked how your first link tended to discount the snowbirds use of american medical facilities as “coincidental”. And how your second link did not inlcude any numbers about waiting times at all. It simply said they are decreasing. ---
**Author:** ![pkbites](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pkbites/32/204_2.png) [@pkbites](https://boards.straightdope.com/u/pkbites)\ **Post date:** [November 9, 2003, 7:21am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/57 "2003-11-09T07:21:49Z")
> [@](#): > > \*Originally posted by Guinastasia \* > **Because that’s reality. And I resent the HELL out of people who imply otherwise!** Oh, you are right on one point: LIFE IS A BITCH! A mean, nasty, ugly bitch. It’s your solution to the bitch that I oppose. ---
**Author:** ![rjung](https://avatars.discourse-cdn.com/v4/letter/r/45deac/32.png) [@rjung](https://boards.straightdope.com/u/rjung)\ **Post date:** [November 9, 2003, 7:34am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/58 "2003-11-09T07:34:40Z")
Given how many folks insist the United States is a Christian nation, I’m surprised they’re not all jumpin’ on board for a national health care plan – after all, wouldn’t that be a way to uphold the principles of Jesus, who selflessly went out and healed the lepers? ---
**Author:** ![Gorsnak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gorsnak/32/7587_2.png) [@Gorsnak](https://boards.straightdope.com/u/Gorsnak)\ **Post date:** [November 9, 2003, 7:35am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/59 "2003-11-09T07:35:06Z")
> [@](#): > > \*Originally posted by pervert \* > But what makes you think the bureaucrat does not care about costs? You said yourself that the system is cash strapped. Does this not mean that it has less money than it needs? Did you not suggest yourself that this may be what is causing the waiting lists? > > Remember, I have several remedys against the bean counter. I can hire someone elseor sue him for instance. Suing your provider is a significant part of the reason you’re paying more than I am for health care, even though I’m paying for all those layabouts and you’re not. 🙂 As for funding and bureaucrats, you seem to be confused about the nature of the system. Funding levels are determined by people who are elected (i.e., the Prime Minister, the Minister of Finance, and the Minister of Health federally, and their provincial counterparts). These people are absolutely concerned about the motivation of voters. Bureaucrats merely carry out the orders their politico bosses give them. Policy level decisions are always subject to voter pressure. Lower level implementation decisions, not so much, this is true. However, to the extent bureaucrats are concerned about the bottom line, they are concerned about the efficiency with which they spend the money allotted to them, not with how much they can keep for themselves, which, again, is a differenct incentive structure. > [@](#): > > If we examine the statistics from my earlier post, it becomes obvious that Canda is not likely to drop the 1 tier health care system soon. So what exactly does the bureaucrat have to fear from your vote? Do you really think that the next president can fire anyone he wants for any reason? I expect (I could be wrong) that firing a bureaucrat can be very difficult. Especially if all he did was apply the letter of the law to the best of his ability. > > Remember, if I don’t like the policy of my insurance carrier, I can change carriers. If you don’t like the policy of your bureaucrat, your are screwed. What does it tell you, that in spite of the difficulties, Canadians, who have vastly more experience with universal public health care than you do, hold views such that it’s political suicide to advocate privatization? Are we all ignorant fools blind to the facts? And who is this president that might be firing people? 🙂 I expect that you’re right that it’s hard to fire bureaucrats. I expect that this doesn’t mean that the regional health adminstrator for greater Vancouver cannot be transferred to a post in Fort Nelson. I will leave it to the reader to determine the difference between being fired and being transferred to Fort Nelly. > [@](#): > > I especially liked how your first link tended to discount the snowbirds use of american medical facilities as “coincidental”. You think that the use of American medical services by people spending 6 months in Arizona is relevant to the question at issue? You think the fact that they don’t fly back to Toronto to see a doctor reveals the inadequacies of Canadian health care? 😕 I think if you want to dismiss that cite, you’re going to have to argue a heck of a lot more persuasively than waving your hands and muttering about bias. ---
**Author:** ![pulykamell](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pulykamell/32/3166_2.png) [@pulykamell](https://boards.straightdope.com/u/pulykamell)\ **Post date:** [November 9, 2003, 7:46am UTC](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049/60 "2003-11-09T07:46:26Z")
> [@](#): > > \*Originally posted by pkbites \* > \*\*My message is not “whoever doesn’t have insurance is a scumbag”. That’s ridiculous! My message is, medical care/insurance is an individual responsibility. Buy a policy, make out a deal with your employer, change jobs to one with bennys, join a union shop, intentionally choose to go without, whatever. But don’t insist that everyone elses tax dollars pay for it. \*\* And I don’t believe medical care/insurance is an individual responsibility. I think it should be a societal one and in the interest of both individuals and a society as a whole. So I pay a couple extra %age points in taxes. Big friggin deal. They’ve already taken my money for a hold-many-billion-dollar war serving no purpose, yet when it comes to an issue with immidiately visible repurcussions and doubtlessly good to the people as a whole, the general population rejects it because it reeks of “socialism.” I don’t understand. What’s the problem with having a basic coverage, and if additional coverage or alternate services are needed, those can be supplemented by the consumer. I lived in a country with a national healthcare system for 5 years, participated for 2 years in that system and have had no problems with the health care provided. The only complaint is longer lines. If I wanted to avoid these, I could visit a private hospital. It saddens me to think that I was better protected under a foreign system than the system of my own country. I believe that taking care of the health needs of citizens is a societal responsibilty. Shouldn’t that be a goal of an advancing civilization? Does social Darwinism have any place in a modern society? I don’t think so. [Previous page](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049.md?page=2) [Next page](https://boards.straightdope.com/t/what-should-national-health-care-be-in-the-usa/212049.md?page=4)