# 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:** 12
**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, 2:26pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/221 "2012-02-13T14:26:59Z")
> [@jjimm](#): > > 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. Internal thought processes which I’ve tried to explain. (although, clearly, unsuccessfully for at least to some of the posters) I apologise for pissing you off, it certainly isn’t my intention. ---
**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, 2:49pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/222 "2012-02-13T14:49:17Z")
> [@bldysabba](#): > > 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. You didn’t have to choose such an obviously frivolous example to illustrate the point though. Again, this seems like an argument that is logically consistent but fails the test of “reasonableness” On one hand a population that is entertained or bored On the other a population that is alive or dead. A better example would be education. We think an education is a right and provide that base level for everyone, by way of tax income, as a way of making society more effective. ---
**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, 2:58pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/223 "2012-02-13T14:58:53Z")
> [@bldysabba](#): > > 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. I don’t know what your definition of ‘middle class’ but I suspect it’s rather wealthier than mine. Most middle-class people I know couldn’t come up with $25,000 in enough time to get the treatment (some would be able to as a loan, though this would be made more difficult by the ill person being, er, ill), and England has a much higher average income than India. I’m willing to bet most Indians can’t actually afford it at all. By you definition of a public good, yes, socially-provided healthcare can be one: Encouraging preventative care and early intervention saves a lot of money treating that illness. It also lessens the likelihood of contracting other illnesses related to the main illness and its treatment (such as illnesses arising from the weak immune system during bone marrow transplants), which also saves the health system money. Being healthy means that the person can carry on working and paying taxes into the system (supporting healthcare) rather than taking resources out. A unhealthy person is more likely to have an an accident (due to a fit, heart attack or tiredness due to illness) than a healthy one (obviously it can happen to healthy people too, just less often), either harming themselves or other people. I think there are other ways that giving people healthcare actually saves the healthcare system money, but the first two points are really enough. ---
**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, 3:14pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/224 "2012-02-13T15:14:56Z")
> [@bldysabba](#): > > 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? _shrug_ The UK NHS is experiencing some of the same inflationary pressures as everywhere else. The cost of most drugs which become available today is hundreds or thousands of times that of older drugs when they became available, partly because virtually every drug launched today is a niche product. The same is true for the Canadian private-provider system. Costs are certainly rising much less quickly in the US, though. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 14, 2012, 9:52am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/225 "2012-02-14T09:52:19Z")
> [@Norse](#): > > I’m a bit curious: What has ethnic homogeneity to do with a functioning government system and ditto public service delivery? :dubious: > [@Norse](#): > > Until you can produce a reputable cite for that claim, I’ll summarily dismiss it as non-fact-based _opinion_ rather than fact. And IMNSHO, non-fact-based opinion fits better in IMHO than here in GD. ETA: Even if conflict as such were unavoidable, you still would have to further support your unstated claim that such conflict would be severe enough to ruin the system of UHC. Also, your cite would have to show more than just some correlations; correlation does not necessarily mean causation. Even if correlation were shown, causation could be in the opposite direction to what you think, _i.e._ that non-functioning or nonexistant UHC is the cause of (ethnic) conflicts, not the other way around. > > Based on your other posts, your general views and opinions seem more than just a little misanthropic to me. While homogeneity isn’t particularly relevant to what we’ve been talking about, here’s a[peer reviewed paper](http://qje.oxfordjournals.org/content/114/4/1243.full.pdf)(pdf) that shows ethnic homogeneity is a significant variable in public spending. Places that are more homogeneous have higher public spending. > [@](#): > > We test the implications of the model with three related data sets: U. S. cities, U. S. metropolitan areas, and U. S. urban counties. Results show that the shares of spending on productive public goods—education, roads, sewers and trash pickup—in U. S. cities (metro areas/urban counties) are inversely related to the city’s (metro area’s/county’s) ethnic fragmentation, even after controlling for other socioeconomic and demographic determinants. We conclude that ethnic conflict is an important determinant of local public finances. ---
**Author:** ![sisu](https://avatars.discourse-cdn.com/v4/letter/s/df705f/32.png) [@sisu](https://boards.straightdope.com/u/sisu)\ **Post date:** [February 24, 2012, 4:36am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/226 "2012-02-24T04:36:32Z")
> [@msmith537](#): > > Personally, I think it should be more like car insurance where you have to have it (unless you qualify not to because you are super-poor or something) and it is not tied to your employer or state. Yep that seems like a reasonable approach. It is pretty much what we have in Australia, although everyone chips into the Medicare system and those on higher wages pay more not only as an amount but also % of income. I can also afford private insurance which I have on top of standard care. There have been times in my life and of people I know that they could not have afforded private health care, it is good to know that they will get excellent care and not go bankrupt just because they got cancer. Poor people get a health care card which gets them “free” health care. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 24, 2012, 5:45am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/227 "2012-02-24T05:45:12Z")
> [@Novelty\_Bobble](#): > > You didn’t have to choose such an obviously frivolous example to illustrate the point though. Again, this seems like an argument that is logically consistent but fails the test of “reasonableness” > On one hand a population that is entertained or bored > On the other a population that is alive or dead. > > A better example would be education. We think an education is a right and provide that base level for everyone, by way of tax income, as a way of making society more effective. Sorry, I must have entirely missed this post earlier. Saw, it after **Sisu** ’s post. Sure it is a frivolous example, but I didn’t intend for it to be analogous. I only wanted to show you that we’re talking about different things. I’m talking about the impact of healthcare on society, and you’re talking about the impact of healthcare on health. I was only trying to illustrate that difference. And just the fact that you don’t immediately think that there is any difference tells me a lot about your(and possibly other people’s) thinking on the issue. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 24, 2012, 6:51am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/228 "2012-02-24T06:51:43Z")
> [@SciFiSam](#): > > I don’t know what your definition of ‘middle class’ but I suspect it’s rather wealthier than mine. > > Most middle-class people I know couldn’t come up with $25,000 in enough time to get the treatment (some would be able to as a loan, though this would be made more difficult by the ill person being, er, ill), and England has a much higher average income than India. I’m willing to bet most Indians can’t actually afford it at all. > > By you definition of a public good, yes, socially-provided healthcare can be one: > > Encouraging preventative care and early intervention saves a lot of money treating that illness. It also lessens the likelihood of contracting other illnesses related to the main illness and its treatment (such as illnesses arising from the weak immune system during bone marrow transplants), which also saves the health system money. > > Being healthy means that the person can carry on working and paying taxes into the system (supporting healthcare) rather than taking resources out. > > A unhealthy person is more likely to have an an accident (due to a fit, heart attack or tiredness due to illness) than a healthy one (obviously it can happen to healthy people too, just less often), either harming themselves or other people. > > I think there are other ways that giving people healthcare actually saves the healthcare system money, but the first two points are really enough. Most Indian middle class _families_ would be able to come up with 25k USD for treatment. According to [this report](http://www.dbresearch.de/PROD/DBR_INTERNET_DE-PROD/PROD0000000000253735.pdf)(pdf), middle class households in 2005(50 million people) had a disposable income between 200,000 to 1 million Indian rupees. To me, a disposable income that high suggests these households could in one year cover the 1.2 million Indian rupees needed for the _most expensive_ procedure on the earlier list, which was probably anyway inflated for international customers. Also, I’m not holding out the Indian healthcare system as a paragon of some sort. Much to my dismay, the Indian government has of late started making health insurance a tax deductible for employers. Predictably, now that the costs are being spread out, costs of medical procedures have shot up in the last couple of years. What is interesting is that many doctors will ask if you have insurance or not, and if you don’t, will proceed to treat you at the old, low rates, clearly showing that the lower rates are worth their opportunity cost. Your other points are good arguments if they hold, but persuasive evidence that they do would be nice. As it stands, I could just flip them around on you. Providing free healthcare is just a moral hazard that encourages people to not take care of themselves. If you knew you may have to bear high costs for your own health, you would be more watchful of your health and fitness. Early intervention definitely need not be prohibitively expensive in an out of pocket expenditure system either. And you’re assuming that healthcare is socialised, so ‘it costs the healthcare system more’. If healthcare isn’t socialised, why care about how much it costs? Sure being healthy means a person can carry on working and paying taxes into the system, but what makes you assume that this is a net benefit to society? In a normal market, any income the doctor/hospital makes from treating him would also be taxed. And if he cannot afford the procedure but gets the treatment under socialised healthcare, the taxes that he would have continued to pay into the system would have been less than the money that went into treating him. One way your point would hold is if you consider lifetime tax payments. But how many people get struck by life threatening illnesses early or in the middle of their working life? What percentage of these people successfully continue with a productive career? Those figures would make convincing arguments. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [February 24, 2012, 9:06am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/229 "2012-02-24T09:06:31Z")
> [@bldysabba](#): > > Providing free healthcare is just a moral hazard that encourages people to not take care of themselves. If you knew you may have to bear high costs for your own health, you would be more watchful of your health and fitness. A lovely bit of just-world, blame-the-victim reasoning there. If only those children with cancer had just taken better care of themselves, their parents wouldn’t be going bankrupt right now! > [@](#): > > Early intervention definitely need not be prohibitively expensive in an out of pocket expenditure system either. And yet it is. Which is the problem we are seeking to address. > [@](#): > > Sure being healthy means a person can carry on working and paying taxes into the system, but what makes you assume that this is a net benefit to society? In a normal market, any income the doctor/hospital makes from treating him would also be taxed. And if he cannot afford the procedure but gets the treatment under socialised healthcare, the taxes that he would have continued to pay into the system would have been less than the money that went into treating him. > One way your point would hold is if you consider lifetime tax payments. Picture any group health insurance plan. Now extend it to everybody. That’s how it works. > [@](#): > > But how many people get struck by life threatening illnesses early or in the middle of their working life? What percentage of these people successfully continue with a productive career? Well, the ones who die for lack of affordable health care definitely don’t. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 24, 2012, 9:42am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/230 "2012-02-24T09:42:06Z")
> [@Gyrate](#): > > A lovely bit of just-world, blame-the-victim reasoning there. If only those children with cancer had just taken better care of themselves, their parents wouldn’t be going bankrupt right now! And yet it is. Which is the problem we are seeking to address. > Picture any group health insurance plan. Now extend it to everybody. That’s how it works.Well, the ones who die for lack of affordable health care definitely don’t. I don’t know what you’re on about. I was asking for evidence to support **Sam’s** points, and demonstrating counter-points that are just as valid from a theoretical standpoint. “Think of the poor children!” is all well and good as an emotional appeal, but fails beyond that. Sure the world isn’t just. And it isn’t the child’s fault that he/she has cancer. But why should that child’s cancer be society’s responsibility? And this is not a rhetorical question. Could you explain your point about group insurance please? And yes, the ones who die because of a lack of free healthcare will surely not be continuing with productive career. Hence I asked if we had any evidence that can lead us to believe this constitutes a net drag on society? ---
**Author:** ![Norse](https://avatars.discourse-cdn.com/v4/letter/n/a9adbd/32.png) [@Norse](https://boards.straightdope.com/u/Norse)\ **Post date:** [February 24, 2012, 10:36am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/231 "2012-02-24T10:36:42Z")
> [@bldysabba](#): > > “Think of the poor children!” is all well and good as an emotional appeal, but fails beyond that. Sure the world isn’t just. And it isn’t the child’s fault that he/she has cancer. But why should that child’s cancer be society’s responsibility? And this is not a rhetorical question. Maybe because, in the mind of some of us, society should not only be governed by purely economical motivations, but that a certain amount of [empathy](http://en.wikipedia.org/wiki/Empathy) should also factor in when society decides what is good and what is bad for itself? Just a bleedin-heart liberal’s gut feeling, mind you. ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [February 24, 2012, 10:41am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/232 "2012-02-24T10:41:55Z")
> [@bldysabba](#): > > Most Indian middle class _families_ would be able to come up with 25k USD for treatment. According to [this report](http://www.dbresearch.de/PROD/DBR_INTERNET_DE-PROD/PROD0000000000253735.pdf)(pdf), middle class households in 2005(50 million people) had a disposable income between 200,000 to 1 million Indian rupees. To me, a disposable income that high suggests these households could in one year cover the 1.2 million Indian rupees needed for the _most expensive_ procedure on the earlier list, which was probably anyway inflated for international customers. The 50 million people figure you chose to use was determined by NACER, while the world bank use a figure of 20 million people: or 20% of the population. So 80% of the population aren’t middle class: which leads me to believe that this “middle class” really isn’t the middle class. In the US definition: roughly 49% of the population are “middle class”, so I suspect the definition of middle class being used by your cite means something completely different to how the rest of us would define it. > **[American middle class | Education and income](https://en.wikipedia.org/wiki/American_middle_class#Education_and_income)** > > Educational attainment is one of the most prominent determinants of class status. Expertise is a necessary component of the capitalist market system, and is seen as one of the factors of production. Those with higher educational attainment tend to be positioned in occupations with greater autonomy, influence over the organizational process, and higher financial compensation. The following chart further explains the correlation between educational attainment and personal as well So you’ve proven that 20% of the population wouldn’t have a problem finding 25K in a hurry. I don’t think that would be different over here either. But what percentage of the population wouldn’t be able to afford $25 K USD for treatment? Surely this is more relevant than just looking at what the “middle class” can afford. > [@](#): > > Providing free healthcare is just a moral hazard that encourages people to not take care of themselves. If you knew you may have to bear high costs for your own health, you would be more watchful of your health and fitness. Early intervention definitely need not be prohibitively expensive in an out of pocket expenditure system either. And you’re assuming that healthcare is socialised, so ‘it costs the healthcare system more’. If healthcare isn’t socialised, why care about how much it costs? Can you provide a cite for a country that has socialized health care that where the population: encouraged by the moral hazard that is free (at the point of delivery) healthcare, have decided not to take care of themselves? ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 24, 2012, 10:49am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/233 "2012-02-24T10:49:41Z")
> [@Norse](#): > > Maybe because, in the mind of some of us, society should not only be governed by purely economical motivations, but that a certain amount of [empathy](http://en.wikipedia.org/wiki/Empathy) should also factor in when society decides what is good and what is bad for itself? > > Just a bleedin-heart liberal’s gut feeling, mind you. It’s a perfectly valid viewpoint to have, and if that’s your major reason for advocating socialised healthcare, it’s good for me to know and keep in mind. It is also a viewpoint that I can understand. I am not an unfeeling robot. It isn’t a great avenue for reasoned debate though, as I mentioned in the OP also. If I _had_ to counter it, with my own gut feeling, I’d say that socialising those parts of healthcare that are a private good(by the economic definition) inflates the prices that the market can bear. By extending the costs of healthcare even to people that do not demand it, it introduces a distortion that reduces the need to serve the market as it exists and does greater damage than good in the long run. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [February 24, 2012, 10:52am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/234 "2012-02-24T10:52:47Z")
> [@bldysabba](#): > > 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? Sorry, I’d lost sight of this thread for a while. Preventative care is also covered under “health services”. In the US, I had to pay to get vaccinated; I had to pay to see a doctor or nurse and for the vaccine, and this after paying for insurance which only covered healthcare and came with a thick smallprint booklet on what was and was not covered. In Spain, I have to see my doctor or nurse. Last month I got a yearly at my local Public Healthcare Center. Half an hour with the nurse; tetanus shot; blood work; five minutes with the doctor (“perfect bloodwork results, stay like that” doesn’t require a lot of time to be said). Out of pocket costs: zero. The out of pocket costs would have been the same if I’d needed any other tests. I can’t tell you how much of the money I pay to Seguridad Social each month goes toward healthcare without dredging up some stats, since it isn’t only healthcare: it also covers retirement, unemployment assistance and other social services. And it covers vaccination programs in schools which are compulsory, and vans going to barrios where kids don’t attend school to get them vaccinated. People are more likely to see a doctor when it doesn’t run the risk of meaning a big chunk of income, and more likely to get vaccinated when there’s an organization trying to get them vaccinated than when it’s completely voluntary. ---
**Author:** ![Norse](https://avatars.discourse-cdn.com/v4/letter/n/a9adbd/32.png) [@Norse](https://boards.straightdope.com/u/Norse)\ **Post date:** [February 24, 2012, 11:07am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/235 "2012-02-24T11:07:16Z")
> [@bldysabba](#): > > if that’s your major reason for advocating socialised healthcare, it’s good for me to know and keep in mind No, it’s not my major reason for advocating public health care, those are more in line with **Nava** ’s recent arguments. But “that” is definitely my primary knee-jerk reaction to > [@](#): > > why should that child’s cancer be society’s responsibility? which I interpret as a heartless and brutal opinion disguised as a question. ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 24, 2012, 11:12am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/236 "2012-02-24T11:12:33Z")
> [@Banquet\_Bear](#): > > The 50 million people figure you chose to use was determined by NACER, while the world bank use a figure of 20 million people: or 20% of the population. > > So 80% of the population aren’t middle class: which leads me to believe that this “middle class” really isn’t the middle class. In the US definition: roughly 49% of the population are “middle class”, so I suspect the definition of middle class being used by your cite means something completely different to how the rest of us would define it. > [American middle class - Wikipedia](http://en.wikipedia.org/wiki/American_middle_class#Education_and_income) > > So you’ve proven that 20% of the population wouldn’t have a problem finding 25K in a hurry. I don’t think that would be different over here either. > > But what percentage of the population wouldn’t be able to afford $25 K USD for treatment? Surely this is more relevant than just looking at what the “middle class” can afford. No it isn’t more relevant. I was trying to show **SciFiSam** that affordable healthcare was possible if an out of pocket expenditure was used to pay for healthcare. This is why I pointed out that the Indian private healthcare system, which exists to serve the middle class, operates at price levels that the middle class is able to afford. The most expensive procedure listed at an Indian hospital, is a procedure that the Indian middle class can, at a pinch, afford. Out of pocket expenditure, in other words, is not necessarily an immediately unviable approach to healthcare. India’s a developing country. It makes no sense to see how much of our population can afford healthcare. In fact, in India there are far more compelling reasons to provide universal healthcare to improve equality of opportunity. In fact, in India universal healthcare does nominally exist. It’s pointless to discuss India’s case unless you have something specific uou can focus on. > [@](#): > > Can you provide a cite for a country that has socialized health care that where the population: encouraged by the moral hazard that is free (at the point of delivery) healthcare, have decided not to take care of themselves? I don’t need to. I’ll retract the statement as soon as I get a cite for the one in response to which it was made. ---
**Author:** ![conurepete](https://avatars.discourse-cdn.com/v4/letter/c/a88e57/32.png) [@conurepete](https://boards.straightdope.com/u/conurepete)\ **Post date:** [February 24, 2012, 11:16am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/237 "2012-02-24T11:16:26Z")
Is there evidence that in a country with no health care other then what individuals can pay out of pocket, people take better care of themselves? I would accept data like evidence of self pay for vaccines, lower smoking and mother and child surviving birth, but longevity and morbidity/mortality are also good. I have not seen anything showing this. ---
**Author:** ![conurepete](https://avatars.discourse-cdn.com/v4/letter/c/a88e57/32.png) [@conurepete](https://boards.straightdope.com/u/conurepete)\ **Post date:** [February 24, 2012, 11:21am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/238 "2012-02-24T11:21:17Z")
Try grabbing the low hanging fruit and cite France, where the population smokes way more then Americans. So there is socialized medicine and people making choices to smoke. (this is me providing the cite Banquet bear asked from you. I know it is a little weak, but discussions move better when we support arguments instead of refusing to cite until the other guy goes first ) ---
**Author:** ![bldysabba](https://avatars.discourse-cdn.com/v4/letter/b/ecccb3/32.png) [@bldysabba](https://boards.straightdope.com/u/bldysabba)\ **Post date:** [February 24, 2012, 11:35am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/239 "2012-02-24T11:35:46Z")
> [@Nava](#): > > Sorry, I’d lost sight of this thread for a while. > > Preventative care is also covered under “health services”. In the US, I had to pay to get vaccinated; I had to pay to see a doctor or nurse and for the vaccine, and this after paying for insurance which only covered healthcare and came with a thick smallprint booklet on what was and was not covered. In Spain, I have to see my doctor or nurse. > > Last month I got a yearly at my local Public Healthcare Center. Half an hour with the nurse; tetanus shot; blood work; five minutes with the doctor (“perfect bloodwork results, stay like that” doesn’t require a lot of time to be said). Out of pocket costs: zero. The out of pocket costs would have been the same if I’d needed any other tests. I can’t tell you how much of the money I pay to Seguridad Social each month goes toward healthcare without dredging up some stats, since it isn’t only healthcare: it also covers retirement, unemployment assistance and other social services. And it covers vaccination programs in schools which are compulsory, and vans going to barrios where kids don’t attend school to get them vaccinated. > > People are more likely to see a doctor when it doesn’t run the risk of meaning a big chunk of income, and more likely to get vaccinated when there’s an organization trying to get them vaccinated than when it’s completely voluntary. Sigh. As I’ve mentioned in the OP, and numerous times since, I consider vaccination to be a perfectly good candidate for socialising costs. Immunity is non-excludable. I don’t have a view on annual screening examinations as part of a public health system. It’s an interesting system, and I’ll be looking it up. I’m also a little sick of everybody beating on the US system as though it is the paragon that I’m holding up. Sure the US system sucks. That’s because (as far as I can tell) of historical baggage, third party health insurance and the legal system. It has little to do with the actual costs of providing health care. Instead of insurance, tax deferred medical savings accounts and out of pocket expenditure would allow the market to work much better. (Public health services would exist independently of this, providing those services that have the characteristics of public goods (as per the economics definition) like vaccination, education about health, sanitation, possibly mandated annual screenings). ---
**Author:** ![Banquet\_Bear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/banquet_bear/32/373_2.png) [@Banquet\_Bear](https://boards.straightdope.com/u/Banquet_Bear)\ **Post date:** [February 24, 2012, 11:40am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/240 "2012-02-24T11:40:54Z")
> [@bldysabba](#): > > No it isn’t more relevant. I was trying to show **SciFiSam** that affordable healthcare was possible if an out of pocket expenditure was used to pay for healthcare. …so what you are saying (using your figures from your cite) is that maybe 30% of the (Indian) population can afford to pay out of pocket. What about the other 70%? > [@](#): > > This is why I pointed out that the Indian private healthcare system, which exists to serve the middle class, operates at price levels that the middle class is able to afford. The most expensive procedure listed at an Indian hospital, is a procedure that the Indian middle class can, at a pinch, afford. Out of pocket expenditure, in other words, is not necessarily an immediately unviable approach to healthcare. It isn’t viable if only 30% of the population can afford it. > [@](#): > > India’s a developing country. It makes no sense to see how much of our population can afford healthcare. In fact, in India there are far more compelling reasons to provide universal healthcare to improve equality of opportunity. In fact, in India universal healthcare does nominally exist. It’s pointless to discuss India’s case unless you have something specific uou can focus on. So, from what you have just written: the Indian health care system is a prime example of one where universal healthcare should be implemented? If it is pointless discussing India: why are you discussing India? > [@](#): > > I don’t need to. I’ll retract the statement as soon as I get a cite for the one in response to which it was made. Your assertion mate. These are your words, are they not? “Providing free healthcare is just a moral hazard that encourages people to not take care of themselves.” Can you provide a cite for a country that provides free (at the point of delivery) healthcare where people do not take care of themselves? [Previous page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=11) [Next page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=13)