# Why is socially provided universal healthcare 'better'? **URL:** \ **Category:** Great Debates\ **Created:** [February 8, 2012, 12:09pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181 "2012-02-08T12:09:40Z")\ **Posts on this page:** 20\ **Page:** 11
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 13, 2012, 10:16am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/201 "2012-02-13T10:16:57Z")
> [@bldysabba](#): > > Also, thanks for your earlier post that you think I’m engaged/open minded. I certainly think I am. But the ‘unreal’ setting of academia that you speak of is what often guides real world actions. Sure it may not be immediate, and indeed may never happen, but answer a question in a way that bears muster for enough people, and your solution will find its way into the real world. In the past, the answers that passed muster were those that sounded the best and appealed to the most people. Today, the gold standard is objective truth. And while it’s harder to come by in the social sciences, I assure you it is not impossible. My concern is always that a watertight argument that speaks to an objective truth can easily break down when subjected to the intricacies of the real world and those pesky humans. I seem to recall communism looking fairly sensible on paper, not to mention the majority of economics strategies have found themselves wanting in recent years (and economics is a BA for a reason). > [@](#): > > Similarly, again as a hypothetical, if peer-reviewed economics found…actually let me flip your earlier question around. I have noted what line of reasoning and also what evidence would convince me that healthcare is a public good. Can you do the same and tell me what line of reasoning or evidence would convince you that it isn’t? I think it is inherent in my discussion of metrics earlier on. It all comes down to cost and coverage, cheaper and more inclusive is the important thing. Simply because sick people don’t work and don’t earn and have miserable lives. Reducing that in the most cost-effective way constitutes a public good for me. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [February 13, 2012, 10:28am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/202 "2012-02-13T10:28:35Z")
> [@Novelty\_Bobble](#): > > I think it is inherent in my discussion of metrics earlier on. It all comes down to cost and coverage, cheaper and more inclusive is the important thing. Simply because sick people don’t work and don’t earn and have miserable lives. Reducing that in the most cost-effective way constitutes a public good for me. And are likely to transmit diseases to others; even more so if they have to go to work/school whether they’re in shape to be there or not. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 10:43am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/203 "2012-02-13T10:43:18Z")
> [@Novelty\_Bobble](#): > > My concern is always that a watertight argument that speaks to an objective truth can easily break down when subjected to the intricacies of the real world and those pesky humans. I seem to recall communism looking fairly sensible on paper, not to mention the majority of economics strategies have found themselves wanting in recent years (and economics is a BA for a reason). Sure. Objective truth only gets determined by interaction with the real world. It has no meaning outside of that, which is where the discipline has been fucking up over the last few years. Mathematical elegance over reality is how Krugman put it I think. Communism/socialism was an entirely theoretical construct based on ‘superior’ moral arguments and had no empirical backing. The stuff I’m talking about is not abstruse philosophy though, and if anything, I’m looking for real world data to validate/disprove the theory. > [@](#): > > I think it is inherent in my discussion of metrics earlier on. It all comes down to cost and coverage, cheaper and more inclusive is the important thing. Simply because sick people don’t work and don’t earn and have miserable lives. Reducing that in the most cost-effective way constitutes a public good for me. So you would reconsider your opinion that everyone has an equal right to access healthcare regardless of ability to pay if a country with UHC performed worse on cost and percentage of people covered than a country without UHC? Provided the two countries are reasonably similar of course ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 11:21am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/204 "2012-02-13T11:21:23Z")
While doing my medicare reading, I came upon this [article](http://www.nytimes.com/2012/02/12/us/even-critics-of-safety-net-increasingly-depend-on-it.html) in the NYT. It’s probably a bad example, given all that I’m hearing about the US system, but it’s the sort of thing I think is likely to happen with socialised medicine. > [@](#): > > Medicare’s financial problems are much worse than Social Security’s. A worker earning average wages still pays enough in Social Security taxes to cover the benefits the worker is likely to receive in retirement, according to an analysis by the Urban Institute. Social Security is still running out of money because the program must also support spouses who do not work and workers who earn lower wages. But Medicare’s situation is even more dire because a worker earning average wages still contributes only $1 in Medicare taxes for every $3 in benefits likely to be received in retirement. > > A woman who was 45 in 2010, earning $43,500 a year, will pay taxes that will reach a value of $87,000 by the time she retires, assuming the money is invested at an annual interest rate 2 percentage points above inflation, according to the Urban Institute analysis. But on average, the government will then spend $275,000 on her medical care. The average is somewhat lower for men, because women live longer. > > Medicare is often described as an insurance program, but its premiums are not nearly high enough. In simple terms, Americans are getting more than they pay for. But many older residents in Chisago say this problem belongs to younger generations. They paid what they were told; they want to collect what they were promised. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 13, 2012, 11:58am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/205 "2012-02-13T11:58:22Z")
> [@bldysabba](#): > > So you would reconsider your opinion that everyone has an equal right to access healthcare regardless of ability to pay if a country with UHC performed worse on cost and percentage of people covered than a country without UHC? Provided the two countries are reasonably similar of course No, I think the right to equal access is non-negotiable. The question is which method best brings that about in the most efficient way. edit - Actually I see your earlier question was on a different tack and I don’t think it is possible to answer as we are now talking about the perception of what a “right” is. It is the equivalent of asking me what evidence would convince me that the right to a fair trial was not a public good. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 12:14pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/206 "2012-02-13T12:14:25Z")
> [@Novelty\_Bobble](#): > > No, I think the right to equal access is non-negotiable. The question is which method best brings that about in the most efficient way. > > edit - Actually I see your earlier question was on a different tack and I don’t think it is possible to answer as we are now talking about the perception of what a “right” is. > It is the equivalent of asking me what evidence would convince me that the right to a fair trial was not a public good. I’m assuming your position is based on moral grounds. Do me a favour and imagine that you’re morally neutral on the issue. What sort of analysis would convince you that healthcare is a public or private good? ---
**Author:** ![SciFiSam](https://avatars.discourse-cdn.com/v4/letter/s/47e85d/32.png) [@SciFiSam](https://boards.straightdope.com/u/SciFiSam)\ **Post date:** [February 13, 2012, 12:45pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/207 "2012-02-13T12:45:28Z")
> [@bldysabba](#): > > I don’t know about chemotherapy. Here’s a medical tourism tour operator’s rates from the web. It shows costs in India being 1/4th to 1/10th the costs in the US). I would link, but that may count as advertising. Take with a fist of salt, but some of the procedures I personally have experience with(lasik, dental, bypass) have reasonable basis in reality (+/- 10%). Keep in mind that these rates are typically at the best hospitals and adjusted upwards for foreign ‘medical tourists’. However, these are also not PPP adjusted, so they’re obviously not apples to apples affordability comparisons. (sorry for the formatting, I tried adjusting it in the post but it doesn’t work. A hyphen denotes that a value for that country is missing) > > ``` > US UK (Private) SINGAPORE INDIA > > ``` > > Bone Marrow Transplant upto 200,000 upto 200,000 - upto 25,000 > Bypass Surgery 35,000 25,000 - 6,000 > Breast Lump Removal - 3,200 1,000 700 > Haemorrhoidectomy - 3,800 1,500 1000 > Knee Joint Replacement - 15,000 7,000 5,000 > Lasik Surgery 4,000 2,800 1,600 700 > No Stitch Cataract Surgery 4,500 2,600 - 700 > In-vitro fertilisation (IVF) cycle 15,000 - - 1,800 > Hernia Correction 2,800 2,700 2,500 1,000 > Dental Implants 3500 2800 1600 800 Thanks for the link. That doesn’t look ‘affordable’ to me. One of the reasons the UK private costs are so much cheaper is that the NHS still covers some care. The Indian prices definitely do not look cheap or as if they’re accessible to most middle-class people. I mean, 25,000? (Dollars, I presume). And that’s just the transplant itself. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 12:53pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/208 "2012-02-13T12:53:56Z")
> [@SciFiSam](#): > > Thanks for the link. > > That doesn’t look ‘affordable’ to me. One of the reasons the UK private costs are so much cheaper is that the NHS still covers some care. The Indian prices definitely do not look cheap or as if they’re accessible to most middle-class people. I mean, 25,000? (Dollars, I presume). And that’s just the transplant itself. For the middle class? It is affordable, but then I don’t know what your definition of affordable is. 25000 dollars, is roughly 12.5 lakh rupees in Indian terms. Indian households pay great emphasis on saving. It will definitely involve hardship, and many families wouldn’t have it as cash in the bank, but it isn’t a back breaking amount. I’m not sure if it’s just the transplant itself or the cost of the entire treatment (the tour operators may quote package deals). Also, keep in mind that this is the rate quoted to Americans. Indians may/may not be paying the same rate. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 13, 2012, 12:58pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/209 "2012-02-13T12:58:32Z")
> [@Novelty\_Bobble](#): > > I think it is inherent in my discussion of metrics earlier on. It all comes down to cost and coverage, cheaper and more inclusive is the important thing. Simply because sick people don’t work and don’t earn and have miserable lives. Reducing that in the most cost-effective way constitutes a public good for me. In a truely democractic society it comes down to choice. Choice based on full information, unfettered by vested interests, bogus nationalism, and political expedience. Let the people choose. The great fear for those behind power in the USA is the knowledge that, once permitted to the people, there is never any going back from UHC. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [February 13, 2012, 12:59pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/210 "2012-02-13T12:59:10Z")
> [@bldysabba](#): > > I’m assuming your position is based on moral grounds. Do me a favour and imagine that you’re morally neutral on the issue. What sort of analysis would convince you that healthcare is a public or private good? See the first posts in this same page. Bad health has negative consequences for the community and spreads; keeping it away is in the communal interest. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 1:02pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/211 "2012-02-13T13:02:53Z")
> [@Nava](#): > > See the first posts in this same page. Bad health has negative consequences for the community and spreads; keeping it away is in the communal interest. See any one of my posts. Communicable diseases do have a good case for being covered under socialised costs. But how much of making sure communicable diseases don’t do more damage is treatment and how much is quarantine, education, sanitation and hygiene? I actually don’t know the answer to this, but I suspect that treatment is the least important part, or at least only one small part of the whole. For all viral diseases for instance(which are definitely among the most contagious), you don’t have any treatment at all. ---
**Author:** ![jjimm](https://avatars.discourse-cdn.com/v4/letter/j/ba8739/32.png) [@jjimm](https://boards.straightdope.com/u/jjimm)\ **Post date:** [February 13, 2012, 1:04pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/212 "2012-02-13T13:04:45Z")
I think some of the confusion here is that some of us are interpreting “public good” to mean “something that is for the benefit of the public”. However I suspect **bldysabba** is using the phrase in its Economics sense to mean roughly “a product, the consumption of which does not diminish its supply”. Quite why he demands that public healthcare be defined as such is beyond me, and my answer is “of course not, but by increasing the pool of services you maximise the chances of it approaching that definition”, but that’s what he’s asking I think. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 1:13pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/213 "2012-02-13T13:13:05Z")
> [@jjimm](#): > > I think some of the confusion here is that some of us are interpreting “public good” to mean “something that is for the benefit of the public”. > > However I suspect **bldysabba** is using the phrase in its Economics sense to mean roughly “a product, the consumption of which does not diminish its supply”. > > Quite why he demands that public healthcare be defined as such is beyond me, and my answer is “of course not, but by increasing the pool of services you maximise the chances of it approaching that definition”, but that’s what he’s asking I think. You suspect? You accused me of coming into this debate with a closed mind after [this post](http://boards.straightdope.com/sdmb/showpost.php?p=14765735&postcount=188) (which I spent an hour thinking about and typing out) explaining why exactly I think healthcare may or may not be a ‘public good’ in the economics sense and why that makes me raise the question of whether or not it should be socialised. If it is still beyond you why I’m asking whether healthcare can or cannot be classified as a ‘public good’, you’re not reading for comprehension, and are missing the fact that **that is the central question on my mind**. Should also explain why you think I’m closed minded. ETA: Can I please request everybody who hasn’t already, to read my response to **Novelty Bobble** in the post linked above? It’s far clearer than the OP. Thank you. ---
**Author:** ![jjimm](https://avatars.discourse-cdn.com/v4/letter/j/ba8739/32.png) [@jjimm](https://boards.straightdope.com/u/jjimm)\ **Post date:** [February 13, 2012, 1:23pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/214 "2012-02-13T13:23:01Z")
> [@bldysabba](#): > > You suspect? You accused me of coming into this debate with a closed mind after [this post](http://boards.straightdope.com/sdmb/showpost.php?p=14765735&postcount=188) (which I spent an hour thinking about and typing out) explaining why exactly I think healthcare may or may not be a ‘public good’ in the economics sense and why that makes me raise the question of whether or not it should be socialised. If it is still beyond you why I’m asking whether healthcare can or cannot be classified as a ‘public good’, you’re not reading for comprehension, and are missing the fact that **that is the central question on my mind**. Should also explain why you think I’m closed minded. Calm down. I’m not an economist, and misunderstood the meaning of the term. That’s not closed-minded in my book, just confused. And from some of the other responses it does look like I’m not the only one labouring under that misapprehension. However, your title asks why it’s ‘better’. You have consistently ignored those responses that inform you of this (it’s cheaper, fulfilling a moral duty that we share, provides herd immunity services), bringing up a couple of vaguely negative articles about specific services in order to dismiss the entire panoply of benefits listed - that is why I maintain that you are in fact closed-minded. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 13, 2012, 1:49pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/215 "2012-02-13T13:49:22Z")
> [@bldysabba](#): > > I’m assuming your position is based on moral grounds. Do me a favour and imagine that you’re morally neutral on the issue. What sort of analysis would convince you that healthcare is a public or private good? Suffering and ill health is detrimental to the effectiveness of a society. Reducing it is beneficial to society, a system of healthcare is therefore required. That is as morally neutral a position as I can manage. If that doesn’t satisfy you I’ll put my dispassionate data analysis hat on and request you show me something like: As healthcare coverage increases, the health outcomes of a nation decreases As health outcomes get worse the living standards of a nation increase People without healthcare are happier than those with. Not an exclusive list by any means but you get the picture. But this would need replication and naturally other variables need controlling for and as we all know, correlation is not causation. I would need to have the causal links mapped out clearly. That is all very difficult to do for the reasons I have mentioned previously. If the above were to be shown with sufficient rigour then I would have to reconsider my position. As it stands, I consider the default position to be the reverse of those statements above and that being the case, full access to healthcare becomes a priority. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 1:50pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/216 "2012-02-13T13:50:05Z")
> [@jjimm](#): > > Calm down. I’m not an economist, and misunderstood the meaning of the term. That’s not closed-minded in my book, just confused. And from some of the other responses it does look like I’m not the only one labouring under that misapprehension. > > However, your title asks why it’s ‘better’. You have consistently ignored those responses that inform you of this (it’s cheaper, fulfilling a moral duty that we share, provides herd immunity services), bringing up a couple of vaguely negative articles about specific services in order to dismiss the entire panoply of benefits listed - that is why I maintain that you are in fact closed-minded. And that title and the OP, I have admitted, did not do justice to my question because my thoughts have evolved by participating in the thread. (I did ask the mods to update the title and OP, but they didn’t think it would be the right thing to do. I can’t say I disagree) I have, as I said before, ignored posts that inform me how certain implementations of socialised medicine have performed better than one implementation of private _health insurance_ because I don’t think they speak to the question I had. If my question had been - which is better, the US system or the British one, I would look at and respond to the posts. And if you’re still bringing up moral duties and herd immunity, I’m sorry, but that makes you the one not participating in good faith(or not paying attention). ---
**Author:** ![jjimm](https://avatars.discourse-cdn.com/v4/letter/j/ba8739/32.png) [@jjimm](https://boards.straightdope.com/u/jjimm)\ **Post date:** [February 13, 2012, 2:14pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/217 "2012-02-13T14:14:58Z")
I apologise for not being able to follow your internal thought processes. Unfortunately, talking to you raises my blood pressure and if I continue to participate I may have to go and see my free-at-the-point-of-delivery health provider, which will raise everyone’s taxes infinitesimally, so I think I shall duck out to avoid that. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 2:16pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/218 "2012-02-13T14:16:30Z")
> [@Novelty\_Bobble](#): > > Suffering and ill health is detrimental to the effectiveness of a society. Reducing it is beneficial to society, a system of healthcare is therefore required. > That is as morally neutral a position as I can manage. > > If that doesn’t satisfy you I’ll put my dispassionate data analysis hat on and request you show me something like: > > As healthcare coverage increases, the health outcomes of a nation decreases > As health outcomes get worse the living standards of a nation increase > People without healthcare are happier than those with. > > Not an exclusive list by any means but you get the picture. > > But this would need replication and naturally other variables need controlling for and as we all know, correlation is not causation. I would need to have the causal links mapped out clearly. That is all very difficult to do for the reasons I have mentioned previously. If the above were to be shown with sufficient rigour then I would have to reconsider my position. > As it stands, I consider the default position to be the reverse of those statements above and that being the case, full access to healthcare becomes a priority. I think I see the divergence. You consider access to healthcare, and society’s duty to provide it to everyone as an absolute. Just as an example, (and for the record, I’m not saying the situations are strictly analogous, it’s just meant to be illustrative), assume I regard entertainment as an absolute right, and socially provided Xboxes the best way to provide entertainment. You ask what would convince me that entertainment is not something that society needs to provide. I reply, Show that as more Xboxes are distributed, levels of entertainment decrease. And quite honestly, I think it isn’t that you’re being disingenuous or anything. It’s that for you, the right to have access to healthcare is just that important in and of itself, without any other considerations. Thanks, that’s also useful. ---
**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:** [February 13, 2012, 2:17pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/219 "2012-02-13T14:17:32Z")
> [@bldysabba](#): > > While doing my medicare reading, I came upon this [article](http://www.nytimes.com/2012/02/12/us/even-critics-of-safety-net-increasingly-depend-on-it.html) in the NYT. It’s probably a bad example, given all that I’m hearing about the US system, but it’s the sort of thing I think is likely to happen with socialised medicine. Except… that isn’t happening with socialized medicine. It’s happening because Americans won’t pay taxes, and because Medicare _only_ covers the most expensive patients (old people). ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 13, 2012, 2:24pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/220 "2012-02-13T14:24:26Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Except… that isn’t happening with socialized medicine. It’s happening because Americans won’t pay taxes, and because Medicare _only_ covers the most expensive patients (old people). Sure, I realise it may not be representative, mentioned that upfront. The article says that people are not paying into the system an amount equivalent to what the expected benefits are. That, I expect, is the taxation issue. Are the other socialised systems that you’re aware of on a sound financial footing? [Previous page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=10) [Next page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=12)