Not to mention that no medication that costs $50K a day would even exist. I can just imagine the reaction to a proposal to work on a drug this expensive. There are expensive drugs, which would get cheaper if more people could afford them, but there are limits.
Here is the quote:
[QUOTE=Lemur866]
OK, I’ll say it. A lot of people would vote for universal health care in a second, if it could be limited to white people.
[/QUOTE]
Since people vote for their own self interest, I don’t think it is much of a stretch to see lots of people meaning lots of white people.
Now Bricker said that he opposes UHC and is non-white. Sure, he’d oppose this (unconstitutional) plan. But that doesn’t say anything about the premise being incorrect. And saying he opposes UHC in principle, which we know already, says nothing about this plan. He is also not many.
Actually no; many, many people vote out of hatred for the poor or women or minorities or whatever other bugaboo they have in ways that hurt themselves. I think it’s hatred of the poor as much as racism (although there’s a lot of overlap), but I do agree that a lot of people hate “them” so much as to oppose universal health care and other “socialistic” policies even if they are impoverished, hurt or die themselves because of it. The hatred is that strong, and that prevalent.
Yeah, I agree you have a point, but in the premise the attack on self-interest was more blatant than usual.
Better than…?
Well, it’s better than not having health care. And there are about 50 million Americans without health insurance, meaning that they have virtually no benefits of preventive care, and a major illness will first financially ruin them and then kill them. You mileage may vary.
Is it better than the health care a billionaire can get? No. We should still let everyone who wants to do it that way do it that way.
So apart from being cheaper, more efficient, more sensible, morally superior, allowing greater preventative care, increasing societal herd immunity, offering coverage for pre-existing conditions, not encouraging the poor to fester while ill until they become an emergency, freeing up the ERs, massive economies of scale, allowing greater mobility in employment, and preventing health-caused personal bankruptcy, what has UHC ever done for us?
There’s suddenly far too much to respond to! There’re a number of interesting points being raised, but Voyager, I think you have the gist of what I wanted to discuss.
I am not at all questioning the value of insurance in general, for which your statements are valid. It’s perfectly true that insurance fulfills a particular demand i.e smooth out the impact of expensive, potentially low probability events. In most areas where insurance is needed (accident, theft etc.), a market mechanism (with reasonable regulation) has proved sufficient to fulfill the demand for insurance. Health insurance however tends to work very imperfectly(if at all) because there is massive potential for market failure through adverse selection (theoretically, and with good empirical basis for for it as well). This is why it isn’t a case of people simply smoothing out spiky risks by paying annual amounts. To prevent this market failure, lots of people(including on this thread) recommend that everybody be mandated to purchase health insurance(or that taxpayers pay healthcare costs. It works out to something similar).
It is to the benefit of only the insurance companies and those more susceptible to health problems to force health insurance markets to function this way.
My contention is that there is no reason to believe that it is to the net benefit of society if everybody is forced to buy health insurance. It perpetuates a model that cannot function because of deep, inherent flaws and prevents a more efficient model from emerging.
In the case of publicly provided healthcare my objections are a tad more strident. Governments in general will almost invariably perform inefficiently and are not incentivised to improve. Healthcare in particular is an area that needs to be fairly and impartially regulated because of big asymmetries of information between provider and patient. If you hand over service delivery to the regulator (by making government responsible for delivery of healthcare) you’re setting yourself up for a very expensive failure.
People don’t have a natural ‘right’ to anything. We collectively agree and bestow upon ourselves those rights we think will make our society a more productive, a fitter, more harmonious place. Some rights tend to be more useful for this purpose than others even if they both purport to achieve the same objective. The ‘right’ to have a say in the selection of those who rule over you, the ‘right’ to freely criticise, and the ‘right’ to hold private property are rights that have worked more effectively to produce stable, functioning societies than has the ‘right’ to healthcare, ‘right’ to education, and ‘right’ to food(My country has these last three in place btw. They’re utter hogwash and do far more damage to all three things than good).
While I suspect this will make you judge me, I won’t react to your high horse until you get on it 
- Yes I do believe it is perfectly moral to let someone die if they don’t have the money for treatment. If they don’t have the money for treatment, somebody’s time and effort has to go to treat them. What gives them a claim on somebody else’s time and effort? You wouldn’t think a strong person has any claim on someone else’s time, effort and expertise because they can take it by virtue of their strength. Why do you think the sick person has a claim on someone else’s time and effort because they can demand it by virtue of their illness? (This is not a rhetorical question. It can have good answers beyond just ‘It is moral’, and it is in hope of finding a satisfactory one that I have started the thread)
Why on earth would properly working markets exclude people with high expected costs? Properly working markets would love people with high expected costs, as long as they can pay for them. (Unless you’re talking insurance markets, about which my views are already laid out above. I don’t think health insurance markets can work very well and positively do not think that forcing everyone to buy health insurance is a good way of making them work)
I don’t have to spend any money on health insurance. My opposition stems purely from the fact that I think universalisation / socialisation of health care is the wrong way of addressing a problem. As a solution it springs from a sentimental approach to the issue which in the long run leads to higher inefficiencies and greater damage to the very people it is intended to help.
I’m curious, bldysabba. You say you’re not American, but where are you from? And where do you ordinarily reside? Because statements like this:
sound like the kind of dogmatically ideological statement often made by conservative Americans who never look outside US borders to see that the rest of the developed world does not in fact fail at this. Sure no UHC systems are perfect, and some are worse than others, but they do seem like less of a fuck-up than the current US system.
I’m Indian, and ordinarily reside in India, but have lived in Europe and briefly in Australia. India has had, and continues to have, a terrible experience with government. It is strikingly evident that the private sector is incentivised to perform and improve, and it does perform better and continuously attempt to improve (including Indian hospitals, about which The Economist has written extensively, and with overly rose tinted glasses of course, but they make some decent points). I am not an ideologue in the least however. There are certain activities that governments need to perform and must perform in order to have good/decent social outcomes. On the other hand, there are activities which government needs to stay out of. Actual service delivery, in almost any field, is one of those. It can work in Scandinavia maybe, but I’m not about to sign on to something just because it worked in a set of countries with a combined (highly homogeneous) population equal to one Indian city.
OK, I can see from your point of view why you would consider “government” incompetent. But I’d like to suggest you use “the Indian government” (and from the sounds of it, “the American government”) when you’re referring to incompetence to run things, rather than “government” as a generic term.
Because it’s not just homogenous Scandinavia governments that deliver healthcare, it’s a large part of Europe including the UK, and east Asia too - Japan, Korea, Singapore, Hong Kong. “Government” in general can in fact run healthcare systems and run them well, if the government is organised enough.
I’m a bit curious: What has ethnic homogeneity to do with a functioning government system and ditto public service delivery? :dubious:
On the contrary, whenever governments extend their reach to start performing functions that are outside of their core activities, over the long run they will generally perform both poorly. You look at some anecdotal partial successes, and ignore some of the monumental failures of an overactive state - the Soviet Union, China, India. There are tens of others. Whenever governments, particularly those of large states, take on too much, they will fail because high monitoring costs and politics mean that activity that causes improvement - in outcomes, productivity/efficiency is not necessarily incentivised.
Btw, here’s one of the Economist articles I was referring to. It gives you an (overly idealised) example of the innovation that is possible when companies don’t have the comfort of spreading costs outside the market that is demanding their services.
At any rate, my question is not, “If socialised healthcare for all was assumed to be a desirable goal, should it be achieved through insurance or public healthcare delivery?”
My question is, " Is socialised healthcare for all a desirable goal? Why? "
I think it is one of those cases where the desire to see healthcare for everybody and the attempt to take the shortest path in sight (mandate it!) actually makes the goal tougher to achieve.
Heh. Just in this thread you’ve had people allege racism will play a role in UHC. I’ve been to Scandinavia and lived there for a couple of months. Even there you can often hear people complain about immigrants who move there, and immediately start mooching off ‘their’ generous welfare state. It is natural for people to see an ‘other’ tribe and seek advantage for their own over the other. I personally despise the tendency. It serves no purpose in the modern world. But to close our eyes to reality does not make reality go away. In a system that is funded publicly, you cannot avoid conflict(of one sort or another) arising from a heterogeneous population.
I think that is terrible failure of imagination and empathy on your part. You are not alone in thinking this but that fails to make it any more palatable to me.
The thinking behind UHC is that, apart from the super-rich, we could all experience medical catastrophes that cost far beyond our means. And there may be no fault involved, just rotten luck, bad timing and any number of elements conspiring to send you up shit creek.
It is this asymmetry of fault/severity/cost that means healthcare stands apart from other insurable items such as cars, houses, electrical consumer goods. If any of those things break you have limited exposure and limited personal risk. Healthcare?..well, you die or experience pain and misery.
We (the UHC countries) have found that by pooling tax revenue (which is de-facto means tested) or mandated low-cost insurance, we can offer a life-preserving and life-enriching level of health care to all which is free at the point of delivery. The claim on time, effort and resources is met by the pool of cash, ring fenced and divorced from the individual.
Again, just to hammer this home, the principle works. It is sound and has proven to be over the last 60 years. No country is seeking a USA style system that leaves people uncovered and bankrupt.
In fact, there is a raft of NHS proposals going through parliament as we speak. Those against the bill are using the threat of a USA style system as one of their main insults. That tells you a lot (incidentally, the proposals do no such thing but the USA threat is proving an effective bogeyman)
Thanks for mentioning these other systems btw. I’ve read up on them, and the only merit they have is, as you noted, that they seem better than the American system. They each have significant drawbacks, including but not limited to, ballooning costs with aging populations(which is causing a nice little storm in the universal single payer systems, as the number of young healthy people who can cross-subsidise the system is now too low), long wait times for non-serious issues (which sort of puts paid to the idea of getting a treatment for a problem before it is serious), and complaints that doctors and hospitals, in an attempt to maximise revenues, suggest non essential procedures which patients go along with since they have nothing to lose. I’m not getting a sense of absolute, clear cut superiority at all.
I could, and do turn around and say that it is a terrible failure of imagination on your part to assume that mandating universal health care is the best way of achieving good healthcare outcomes for the largest number of people. It abstracts decisions about what care is to be sought and sanctioned away from patients, families and doctors and hands them to legislatures. It prevents, or at the very least, removes incentives for innovation and cost reduction by farming out costs among the healthy and the young like some sort of inter-generational ponzi scheme. As for a failure of empathy? I have parents and grandparents whose medical costs are my responsibility. It needs no empathy for me to know the impact of medical costs. I have felt the impact, and expect to do so again. Doesn’t mean I think it’s moral to claim from someone else that which I haven’t earned.
(There are important caveats to this line of thinking for me. One is that not everyone in my country has the opportunity to an education and basic healthcare in their childhood. That’s an area where I think government does have an important role to play, because it is the sort of intervention that leads to massive positive externalities for minimal costs. Easily justifiable. But even there, I don’t recommend that government actually deliver the services. Only that it provide the very poor a means of participating in the market for these services through vouchers or cash transfers)
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.
Since Scandinavian homogeneity is not in the least central to anything I’m talking about, I’ll happily retract it. If you want me to accept the Scandinavian model as a replicable one, you’re free to try and convince me.
Based on your posts, you seem to be happy to fixate on incidentals and to fling around ad hominems rather than engage the topic proposed for debate. There. Are we good?
Ballooning costs may be dismissed as insurance-paid systems are prone to them too.
The other advantages of UHC have been detailed above. As I said, no system is perfect. The sense of “absolute, clear cut superiority” is of course not going to be found: it is shades of grey. However if you want one aspect where UHC is towering head and shoulders above a private-insurance-only system, just browse MPSIMS and the Pit on these very boards. Find me a single non-American who’s talking about putting off a doctor visit, or can’t afford their prescription medicine, or who has been bankrupted by medical fees, or attended an ER for a trivial complaint, or can’t get insurance because of a pre-existing condition, or can’t leave a shitty or low-paid job due to the loss of medical insurance. I have read every single one of those circumstances on the SDMB over the past few years, and not one thread on those topics was started by anyone in a country with a UHC system.
Speaking purely personally, I too have lived under both systems and I know which one I prefer.
Finally, it’s not a zero-sum game in most UHC countries. They don’t preclude private medicine. For example in the UK I had private health insurance that came with my job. Usually I just used the NHS for trivial matters and GP visits, but I did occasionally use it to jump the queue for specialists.
To be honest, your response above makes it look like your original OP wasn’t particularly sincere: that you had made up your mind before this thread that UHC isn’t the solution, and despite the dozens of posts giving you the information you originally asked for about why it’s ‘better’, you’re choosing to ignore them. For an Indian you do sound suspiciously like an American conservative.
But the *universal *part of it rather gives the game away doesn’t it? In order to cover the largest number of people it has to be UHC, by definition. The only question then is how to fund it. I suggest you look at the the various funding options chosen by the European countries.
Most choose to pool resources for roads, schools, police and justice, military and none of those are seen as too controversial. Many other countries such as my own choose to do the same for healthcare and again, it isn’t controversial.
As for me? I go where the evidence takes me regardless of my gut feeling. I look at the UHC’s and they cost less, deliver more and cover more people than the alternatives. If you have a better system to suggest then go for it and show me.
Do you have an example of this? as I’m not sure what you mean. If it were all left to insurers (a la USA for instance) then yes I can see your point, an external body (the insurance companies) get to decide the level of care and that is not based on medical needs. But that is a bad thing surely? that can’t be the point you are trying to make.
It spreads the costs to those able to bear it,* while *they are able to bear it. The payback of that social contract is that you won’t need to worry about the costs yourself should you need help.
This is perfectly sensible and extremely popular because as I said upthread, healthcare isn’t comparable to any other type of insurance.
Empathy is if you can put yourself in the position of the poor mother who’s daughter is dying of liver failure and cannot afford a transplant. Or the diabetic who can live a productive life if they are provided with treatment. Who knows, with such help they may become well enough to study and work and become a doctor who can help treat your grandparents. Earning lots of lovely money that will be taxed and so help to treat others in society.
And those countries with UHC simply push that boundary back so that it covers you at all ages, not just childhood. And it does so for exactly the reasons you state here. You are not so far away as you think you are.
This is the failure of imagination I mean. The governments with UHC often don’t directly deliver the services themselves, external organisations are set-up or employed to do it. The government just handles the revenue, pools it and distributes it for the clinicians and healthcare experts to work with.