# 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:** 7
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 9, 2012, 8:24pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/121 "2012-02-09T20:24:24Z")
^ On all data it plainly doesn’t do either of those things. If it did, 20-30 first world economies would have nothing to do with UHC - unless we’re all completely stupid. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 9, 2012, 8:38pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/122 "2012-02-09T20:38:56Z")
> [@bldysabba](#): > > I can give an example of how India’s system functions. Now obviously, Indian healthcare is very far from being the best in the world. But it is cheap. We have a ‘universal’ government run free healthcare system, but until a few years ago, approximately 80% of all spending on health was private, because the government system is screwed up beyond belief. You probably couldn’t walk into a government hospital in India. (I have, into literally hundreds. I worked on a consulting project with the government to improve service delivery in hospitals 🙂 ) > > So because of this failure there’s a thriving private sector. And treatment is reasonably cheap because there is competition and there is demand from people who cannot afford to pay, but cannot pay a lot. And they also do not have the government to pay for them or insurance. But that demand exists and is unfulfilled, which is causing companies to innovate and look for ways to serve this market with lower costs and reasonable quality. [Here’s](http://www.economist.com/node/13496367) the economist article again, which basically fleshes out what I’ve written in this paragraph. There are several models of UHC where getting private care is allowed. I’m more or less for it, because if you didn’t you would soon have a black market in private care. The problem is - and India might be an example - if the power elite do not use the universal system, they have no incentive to make the universal system better. In the US we have universal public education, but anyone wishing to put their kids in (regulated) private schools is allowed to do so. Again, the danger is that those who do have less incentive to approve funding to make public schools work. If you have massive income inequality you also have a problem, since whatever system you have splits into one for the haves and the have-nots. We have very few hospitals for the very rich, since those with decent insurance can afford decent hospitals, but I see how that can change. > [@](#): > > In a socialised or universal healthcare system on the other hand, the incentives for doctors and hospitals would not lie solely in lowering costs or improving services. The incentive there would be to lobby government for higher premiums. It would cause what seems to me to be an unnecessary distortion in the market. Is there any compelling reason for this distortion to exist, aside from subjective interpretations of morality? What actually happens is totally the opposite of this. Government has more power than private insurance companies and especially individuals, so in the US the “socialized” plan - Medicare - has enforced lower prices on care providers. My step-brother is a shrink and his wife complains about this all the time. In fact the legislature has to weigh letting a small set of providers charge more against a large set of taxpayers paying less, and always comes down on the side of the taxpayers. Some argue that this drives efficiency into the system - perhaps. Also, insurance providers who are regulated are allowed a certain return on their sales, and so have an incentive to raise prices so long as everyone else does. If you doubt this model I can relate how I worked in a funding paradise when I started with the Bell System for this very reason. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 9, 2012, 8:43pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/123 "2012-02-09T20:43:31Z")
> [@Really\_Not\_All\_That\_Bright](#): > > _Why_? Can you actually come up with a plausible reason why government shouldn’t run healthcare, other than “waaah! It’s socialism!”? I can. In the US switching to a government run system (NHS model) would be incredibly disruptive, while switching to a single payer model wouldn’t be disruptive at all and in fact would immediately drive a lot of cost (dealing with n insurance companies) out of the system. It turns out that during the war Britain has an NHS system due to many people moving to the countryside away from their usual providers and other things. When they adopted one they actually were continuing what had sprung up out of necessity. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [February 9, 2012, 10:06pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/124 "2012-02-09T22:06:00Z")
> [@Novelty\_Bobble](#): > > shouldn’t? what a strange choice of words. Surely you want your government to be making the most efficient use of your tax dollars. Why would you reject a solution out of hand even when it has proven to be better than your current system and decidely not a stepping stone to socialism (note…the UK has become _less_ socialist since the inception of the NHS, not more). > I think we are back to that previously mentioned gut reaction. I don’t think your opposition to UHC is based on a rational argument and I’m not sure what evidence would convince you otherwise. > > As for legislation, how about fixing a maximum policy price, mandating a minimum coverage, getting rid of lifetime limits, setting a maximum deductable for all, specifying exemptions for those on welfare and other vulnerable groups, setting up an independent clinical body to judge which treatments go to whom, taking away the insurance company’s ability to refuse coverage…? Those would get you on the road to a fair system and wouldn’t stop those that can pay more getting better and quicker treatment. Everyone is happy (apart from the health insurance companies) Primarily the “proving to be more effective” part. If they had proved that, I’d have no qualms. ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [February 9, 2012, 10:07pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/125 "2012-02-09T22:07:02Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Your beliefs are irrelevant. “It’s not good because I don’t like it” is effectively a circular argument. > > As far as “unaffordability”, feel free to peruse the numbers I posted on the first page of this thread. What is “unaffordable” about a system which would cover every citizen for a fifth of the cost of covering 75% of them? It is only affordable when you force everyone to buy in. How is that coming? ---
**Author:** ![Bozuit](https://avatars.discourse-cdn.com/v4/letter/b/edb3f5/32.png) [@Bozuit](https://boards.straightdope.com/u/Bozuit)\ **Post date:** [February 9, 2012, 10:17pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/126 "2012-02-09T22:17:25Z")
> [@bldysabba](#): > > Wow. You really blindsided me with that. Sheesh. Read my posts. Law and order and infrastructure are clearly defined public or quasi-public goods. The case for government/social provision is clear cut. I wouldn’t say it’s necessarily “clearly defined” that a system with private security in place of police, with each individual or family (whoever it is that normally pays for health insurance I suppose) paying one of a number of security firms to protect them as necessary, or a system where road users are charged according to usage, is clearly more unreasonable than a system where people have no choice but to manage and pay for their own health insurance or risk very serious problems. ---
**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 9, 2012, 10:27pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/127 "2012-02-09T22:27:00Z")
> [@Kearsen](#): > > Primarily the “proving to be more effective” part. > If they had proved that, I’d have no qualms. So what would be your metric for effectiveness? let’s have that clear first of all before we tot up the scores. ---
**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 9, 2012, 10:42pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/128 "2012-02-09T22:42:53Z")
> [@Voyager](#): > > I can. In the US switching to a government run system (NHS model) would be incredibly disruptive, while switching to a single payer model wouldn’t be disruptive at all and in fact would immediately drive a lot of cost (dealing with n insurance companies) out of the system. > > It turns out that during the war Britain has an NHS system due to many people moving to the countryside away from their usual providers and other things. When they adopted one they actually were continuing what had sprung up out of necessity. The NHS _is_ a single payor system. The government pays for everything. You’re not taking about payor models, you’re talking about provider models. > [@Kearsen](#): > > It is only affordable when you force everyone to buy in. How is that coming? _shrug_ It’s coming fine, except for the Tea Party. The whole point of socialized medicine is that you don’t _have_ to buy in. Healthcare is paid for via tax revenues, just like other government services. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 9, 2012, 11:22pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/129 "2012-02-09T23:22:26Z")
> [@Really\_Not\_All\_That\_Bright](#): > > The NHS _is_ a single payor system. The government pays for everything. You’re not taking about payor models, you’re talking about provider models. I thought doctors worked for NHS for the most part. The right seems to use “government run healthcare” as a strawman for the government taking over and employing all the doctors and owning all the hospitals. All the proposals are for single payer systems. The mantra that UHC means the government owns all of healthcare is just another big lie of the right. This might or might not make sense in the future, but it isn’t even on the table. It seems the only thing between us and a reasonable single payer system are lobbyists for the insurance companies and those who see a socialist under every bed. All I know is that when my daughter did a year of college in Germany she had to buy health insurance - and the cost was trivial, far less than here. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 9, 2012, 11:48pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/130 "2012-02-09T23:48:19Z")
Its really just like education. Does the gov “own” education, no it makes a budget from tax revenues, oversees policy direction - presumably direction based on the manifesto that party was elected on - and lets the professionals run the system. ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 9, 2012, 11:53pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/131 "2012-02-09T23:53:16Z")
I don’t understand this idea of gov owning anything anyway - gov owned means it’s publically owned i.e. by the people. The people _own_ the hospitals and equipment in a UHC, though I’ve never heard anyone think or describe it in those terms. It’s just _ours_, and god help any gov that messes that up. ---
**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 9, 2012, 11:56pm UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/132 "2012-02-09T23:56:46Z")
> [@Voyager](#): > > I thought doctors worked for NHS for the most part. The right seems to use “government run healthcare” as a strawman for the government taking over and employing all the doctors and owning all the hospitals. All the proposals are for single payer systems. That is a single payer system. It’s also a single provider system. Single payer just means one entity (the government) pays for everything. Canada is a single payer, multiple provider system. ---
**Author:** ![Bozuit](https://avatars.discourse-cdn.com/v4/letter/b/edb3f5/32.png) [@Bozuit](https://boards.straightdope.com/u/Bozuit)\ **Post date:** [February 10, 2012, 12:21am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/133 "2012-02-10T00:21:22Z")
> [@PrettyVacant](#): > > I don’t understand this idea of gov owning anything anyway - gov owned means it’s publically owned i.e. by the people. > > The people _own_ the hospitals and equipment in a UHC, though I’ve never heard anyone think or describe it in those terms. It’s just _ours_, and god help any gov that messes that up. Exactly. In the UK we refer to things as “publicly owned”, not “government owned” and the focus (at least officially) is always on providing a good service that’s good value. We don’t look at it suspiciously or really even associate the NHS and the government in our minds. ---
**Author:** ![amanset](https://avatars.discourse-cdn.com/v4/letter/a/8dc957/32.png) [@amanset](https://boards.straightdope.com/u/amanset)\ **Post date:** [February 10, 2012, 1:29am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/134 "2012-02-10T01:29:04Z")
> [@gatorslap](#): > > Google tells me 900 SEK is about $135. That’s chump change. Be glad you are so well off that 135 USD is “chump change”. Unfortunately for many in society it is not. It is also still 135 USD more than the UK charges. ---
**Author:** ![Ximenean](https://avatars.discourse-cdn.com/v4/letter/x/aca169/32.png) [@Ximenean](https://boards.straightdope.com/u/Ximenean)\ **Post date:** [February 10, 2012, 2:25am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/135 "2012-02-10T02:25:56Z")
> [@Bozuit](#): > > Exactly. In the UK we refer to things as “publicly owned”, not “government owned” and the focus (at least officially) is always on providing a good service that’s good value. We don’t look at it suspiciously or really even associate the NHS and the government in our minds. Speak for yourself. NHS policy is decided by the government, which is chosen by the public. Controlling something is tantamount to owning it. I see no real difference between something being government-controlled and it being publicly owned. And, the NHS is a major political issue. ---
**Author:** ![Whambulance](https://avatars.discourse-cdn.com/v4/letter/w/e9a140/32.png) [@Whambulance](https://boards.straightdope.com/u/Whambulance)\ **Post date:** [February 10, 2012, 6:46am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/136 "2012-02-10T06:46:07Z")
> [@Alessan](#): > > Because it makes life easier. > > When I worry about my health, all I have to worry about is my health. I don’t have to worry about money. Likewise, when I worry about money, I don’t have to factor in my health - which means that I know that whatever monetary or career choices I make, my health is covered. This makes life a whole lot less worrisome. This is about the most convincing and succinct argument I’ve heard for socially provided universal healthcare … but given I live in the States and I experience first hand our governments unimaginable ability to waste our money I think I’d prefer a repaired version of the system we have now (prior to the Obama changes). I literally stood in line and talked on the phone virtually every day for 3 weeks trying to get a copy of a marriage certificate last year. I am not exaggerating when I say that upwards of 75 city and state employees WITHIN the departments responsible passed the buck and dropped the ball until I finally had a sympathetic judge find the file for me on his lunch break. The government simply does not have the motivation to perform to a high enough standard and there isn’t enough accountability. (at least here) ---
**Author:** ![PrettyVacant](https://avatars.discourse-cdn.com/v4/letter/p/49beb7/32.png) [@PrettyVacant](https://boards.straightdope.com/u/PrettyVacant)\ **Post date:** [February 10, 2012, 7:33am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/137 "2012-02-10T07:33:55Z")
> [@Ximenean](#): > > Speak for yourself. NHS policy is decided by the government, which is chosen by the public. Controlling something is tantamount to owning it. I see no real difference between something being government-controlled and it being publicly owned. And, the NHS is a major political issue. The difference is a gov has a short-term mandate to run the NHS, the public then periodically decide whether they like the way i’s been run. And if they don’t… I see than as akin to management vs. shareholders. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 10, 2012, 7:56am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/138 "2012-02-10T07:56:16Z")
> [@Really\_Not\_All\_That\_Bright](#): > > That is a single payer system. It’s also a single provider system. Single payer just means one entity (the government) pays for everything. > > Canada is a single payer, multiple provider system. The point which I have been trying to make is that the US could go to a single payer system fairly easily, while going to a single provider system would be disruptive. Further, conservatives distort proposals for a single payer system into ones for a single provider system. Obviously single provider systems are also single payer. I didn’t think that needed saying. ---
**Author:** ![Invisible\_Chimp](https://avatars.discourse-cdn.com/v4/letter/i/f05b48/32.png) [@Invisible\_Chimp](https://boards.straightdope.com/u/Invisible_Chimp)\ **Post date:** [February 10, 2012, 8:03am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/139 "2012-02-10T08:03:13Z")
> [@Whambulance](#): > > This is about the most convincing and succinct argument I’ve heard for socially provided universal healthcare … but given I live in the States and I experience first hand our governments unimaginable ability to waste our money I think I’d prefer a repaired version of the system we have now (prior to the Obama changes). > > I literally stood in line and talked on the phone virtually every day for 3 weeks trying to get a copy of a marriage certificate last year. I am not exaggerating when I say that upwards of 75 city and state employees WITHIN the departments responsible passed the buck and dropped the ball until I finally had a sympathetic judge find the file for me on his lunch break. > > The government simply does not have the motivation to perform to a high enough standard and there isn’t enough accountability. (at least here) Why do you think the US government is especially incompetent compared to other Western industrialized democracies that do provide UHC? I don’t see anything that separates them from all the others. I think the US gov’t. would be no worse than any other at UHC. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 10, 2012, 8:05am UTC](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181/140 "2012-02-10T08:05:40Z")
> [@Whambulance](#): > > I literally stood in line and talked on the phone virtually every day for 3 weeks trying to get a copy of a marriage certificate last year. I am not exaggerating when I say that upwards of 75 city and state employees WITHIN the departments responsible passed the buck and dropped the ball until I finally had a sympathetic judge find the file for me on his lunch break. > > The government simply does not have the motivation to perform to a high enough standard and there isn’t enough accountability. (at least here) Gee, I spent hours on the phone with the phone company. Let’s do away with private enterprise. :rolleyes: I had to get a new license a year or so ago, and went to the dreaded motor vehicle bureau. They allow you to make appointments, a guy administered eye tests while we were waiting in line for something else, and I was out of there in under an hour. I could get the forms to order copies of my father’s death certificates on-line. I had to get it notarized, but it was simple. Even better, when I needed an EIN for his trust, it was done immediately and a number assigned and a letter for it generated on the IRS website - no phone calls, no people, done in under five minutes. The right wing assertion that government never does anything right is a big heaping pile of bullshit. Businesses are in business to make money - if serving customers meets that goal they will, if screwing customers meets that goal, they will do that. Our health care system demonstrates this quite well. [Previous page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=6) [Next page](https://boards.straightdope.com/t/why-is-socially-provided-universal-healthcare-better/612181.md?page=8)