I agree. If you can get a majority of the voters to agree with you, maybe something could be done about it. As it is now, we have a military and we are stuck paying for it.
This also applies to the fire department - we already have it because that is what the majority wanted.
Again, that is something you will have to take up with the voters. Complaining about current money wasting government programs isn’t doing much for your position.
Does the current US Postal Service break even? If not (and Wikipedia says it doesn’t), it gets letters from Maine to Hawaii for 42 cents, plus $5.14 billion per year in taxes. Claiming that the government can actually do it for just 42 cents is exactly why we don’t want people like you implementing universal health care - because people overlook how many taxpayer dollars are going to be used to prop up this “free” healthcare.
You’re confusing ‘national’ with ‘universal’ (which, honestly, seems to happen a lot in these discussions). In Canada, this happens to be the same thing, but there are other countries which have managed to implement universal healthcare without turning the government into the default insurer. There’s multiple examples of systems we could emulate–I wish the discussion would turn to which one to use instead of if we should have any at all.
The reason people can get group insurance, but not individual is that a group spreads the risk around. So let’s just spread the risk around the entire population. Those that can’t get it via a group plan for whatever reason can opt in to the wider government plan. I fail to see how allowing people to pay for a plan that already exists could cost tax payers more.
What will cost is paying for people that can’t afford insurance, but if we can eliminate the profit centers of the insurance companies, it should help to balance it. No other people around the world worry about a health issue bankrupting them. I would rather pay slightly higher taxes to ensure all Americans can remain healthy and in the workforce.
I suppose the fact that every single industrial nation that has UHC does it more cheaply than our current system doesn’t prove anything?
What you really want is for UHC supporters to create an alternate universe with a US that has UHC, pull the financials, and then try to “prove” that what worked in universe #2 will work here as well.
Desert Nomad, if you don’t want a military then you won’t have a Nevada to come home to, but you already knew that was a specious argument. People should pay for the fire department because if thier neighbor’s house catches fire, it’s possible for the fire to spread to thier own. Ditto for the police and all of the other weak ass “these are socialized tooooooo” whining. In the words of the Cookie Monster: “One of these things is not like the other…”
Simply put, the government is not designed or prepared to be efficient, and will not bring efficiency to healthcare. Bureaucracy will not be reduced, but increased. Other countries with the high standard of socialized care that others point to are servicing populations that are smaller than the US population. And for whoever brought up the post office, I’d suggest that performing open heart surgery is a little more complex than putting a letter in a box.
The simple answer to the OP’s question is: It’ll cost more.
Other than an emergency subsidy after the 9/11 attacks, the USPS hasn’t received government money in 26 years and routinely makes huge profits.
Do you honestly believe that? I think we need a military to defend the USA, but am not so sure that 57,000 troops in Germany nor 3 in St. Helena are required. The money spent on excessive military could easily pay for any additional health care costs.
As more and more business fail, we are going to see a huge spike in the uninsured… and when a business fails, there is no COBRA option.
Mostly out of curiosity, I applied for health insurance again today, both as a group and as an individual. I expect to be declined for both. I understand that once you have a group plan, they can’t decline you, but getting a plan in the first place at an affordable cost (i.e less than I earn) has never been possible.
How, exactly, does a larger population mean that the cost per capita has to be higher? If I pull together a handful of European countries to equal the US population, their costs are going to be lower than ours, even though the total population is the same.
Maybe the way to do it is to have an East, Central and West health care, with the population divided up, it’ll be cheaper.
Does the term “economy of scale” mean anything to you at all? Insurance is all about large pools. An insured pool the size of the US will be far more efficient than one the size of Luxembourg. Ditto for overhead. Do you think an office of 10 people has less overhead than an office of 1,000?
BTW, notice that private Medicare insurers are more expensive than the public one. I’m not totally sure if that is because their costs are higher or because Bush was ripping off the public once again, but there are many cases where the government runs things more efficiently than private enterprise. Do you think the army running facilities in Iraq would have cost more than Halliburton?
You say it will cost more because it is an item of faith to you. That’s just economic creationism.
Bingo. This is the A Number One reason why UHC is inherently cheaper - it spreads the risk over a wider pool. That’s insurance 101. The only way an insurer with a smaller base can match one with a larger base is to throw high risk participants to the sharks. This is so simple, people!
You’re right, I misread the symbol used for falling income as negative income.
Economies of scale have nothing to do with it. The problem with insurance is information asymmetry. You can fix that with random sampling.
In other words, insuring 10 people randomly selected out of the population is no more expensive on an individual basis than insuring 10,000. In other words, it’s not the size of the population that brings efficiency, it’s the randomly selected nature of it.
Any comments on the plan I posted earlier? It addresses this problem without requiring a massive government takeover of health care, and without abandoning those market forces which help keep prices down and which drive good behavior.
Sorry, I’m not going to get into the “Bush is a bad bad man and Halliburton is eeeevil” thing with you. All that is bad does not begin and end with the presidency of George Bush. That’s your particular article of faith.
I’m saying it will cost more because it will. The savings you claim come from eliminating the for-profit bureaucracy and replacing it with a government one - government is not efficient. You can’t replace one large, inefficient bureaucracy with another, larger one and claim that it’ll be more efficient. Medicare/Medicaid are rife with fraud, waste, and rising expenses - spending nearly doubled under your personal Satan’s watch and the program still has finance problems. The VA can’t properly care for a few million ex-soldiers, as evidenced by the problems at Walter Reed and the anecdotal evidence supplied by my twice decorated, wounded in Iraq I brother. All three of these programs are government run fiascos, and you want me to buy into yet another?
Overhead per capita is one consideration, but would you rather your request for care to circulate through an office of 10 or an office of 1000? Economy of scale is one thing, but my current economy of scale (my private insurance provider) does not include in my premium the cost to carry an additonal 14 percent of the insured pool. Yours does. How is that less expensive?
You might not like what we have now, but we insure roughly 86% of our population with the finest medical care in the world. The expense goes to pay for breakthrough treatments for diseases considered uncurable 25 years ago. If that money goes away, where exactly do you expect the next breakthrough to come from?
Finally, you have just as much data as I do on how expensive the whole thing will be: none. Sure theories abound, but theory isn’t fact and can only be proven by experimentation. If this experiment fails, what’s the back out plan?
It costs the tax payer if the government plan is required for everyone. If it isn’t, how are those who (truely) cannot afford a private policy now going to be able to afford one under your plan? Unless the government underwrites it? All of the plans that I have seen advocated are one of these two - either we all have to join a national government run plan, or we essentially extend Medicaid to people who are making more money than the maximum now.
It wouldn’t be slightly higher taxes and it wouldn’t ensure that all American stay healthy and employed. You like assuming that what is going on in other countries will work here - do all of those other countries have a population that is completely healthy and employed?
Yet, somehow, every industrialized nation (except the US) has this large inefficient bureaucracy and they’re ALL more efficient than the US system.
Every.
Single.
One.
Tell me again how, “logically”, government run medical care is less efficient than privately run medical care, because that argument never gets tired.
As an aside, you’re bitching about paying for the coverage of 40 million people, while admitting that the high cost of our system funds research so that billions of people across the world have access to new treatments at half the price we pay.
Why don’t we stop funding research for the entire world, we’ll have oodles of money left over to pay for poor folks to get decent care.
My biggest concern would be the gap you have left between no medical treatment and catastrophic medical treatment where people have to fend for themselves. Especially for maintenance things–does the government program cover the diabetic’s insulin, or do they have to find a way to pay for it themselves until complications set in and the government program picks it up*? I’m not sure if what you’ve proposed would really be much better than what we have now, because that gap already exists. The idea of nudging people to save towards healthcare sound good on paper, but I can’t help but wonder what effect it would have on the lower classes (I’m not even going to guess here–my experience is far too limited).
Changing regulations to help increase supply is probably something that needs to be done anyways, so I’m not going to argue that point.
I don’t think that private insurers need to be kicked out of the market–even in Canada they exist, but prices are far lower because the costs they cover are already low. I do think that whatever happens, we need to ensure that everyone has more than catastrophic coverage. The small things affect us negatively too–I wouldn’t be able to be a productive member of society without my antidepressants, but I’m pretty sure there isn’t any definition of catastrophic that would include mild mental illness, nor should there be. Covering that sort of gap is where I think the most societal good would happen.
Just my $.02
*I’ll admit to being a bit confuzzled on the bit about the government being an ‘intermediary’. The fact that I already have a headache isn’t helping.
Except, you don’t know that. Just looking at bare facts doesn’t tell the whole story - how much of the taxes an individual pays from any given country go to support their UHC? What is the quality of care? What is the average income for a doctor? Where do they get their drugs and medical equipment? Do they have anything like the FDA? What are their wait times? Do they have access to everything medicine offers?
Even if it were true that every single nation with a UHC does it cheaper doesn’t mean it would happen here. Are you just going to cut salaries across the board in the medical field? What about all the folks working for insurance companies? What about the expense of medical school? Do you honestly think that just because we have a UHC here, medical prices will suddenly drop?
No, what I really want is for people to actually think about this rather than just stomp their feet and point at some other country for “proof”. I know it’s too much to ask people to stop being selfish, but the least you all can do is recognize the realities and actually attempt to prove that a UHC here wouldn’t end up costing me more and/or provide less.
I keep hearing this asserted, but the data that is offered to back up this assertion is always some aggregate measure of per-capita health care spending, correlated with dubious stats like like expectancy.
To truly decide whether market-based health care is more or less efficient than govenment-run health care, your analysis is going to have to do the following:
Control for variation in population health. The U.S population is more obese than other populations, and has other health issues that may or may not affect the cost of health care.
Control for wealth. Wealthier people have more disposable income and demand higher levels of health care. The U.S. has one of the highest per-capita incomes in the world. It should be no surprise that they choose to spend more on health care.
Control for ‘health tourism’. The U.S. has a significant influx of wealthy foreigners who come to the U.S. for treatment. It’s usually the most expensive kind of treatment, and it skews the statistics. Americans rarely travel to other countries for treatment. That alone should tell you something about the quality of care available in the U.S. to those who can afford it, but in any event it also makes health care look more expensive on average.
Control for level of service. You can’t compare costs of two systems if one of them disallows treatments that are available in another, or uses waiting lists or other mechanisms to ration care. In addition, you have to control for things like neo-natal care, which is much more expensive in the U.S. in part because the U.S. goes to great lengths to save premature infants and spends more money for the care of ‘at-risk’ pregnancies.
Control for population age and birth rate. The U.S. has a much higher birthrate than does Europe. That obviously drives up the cost of health care related to pregnancies and neo-natal care.
Control for outliers, such as health care for the super-wealthy. How much of the U.S.'s per-capita spending is driven up by wealthy people who demand gold-plated service, private rooms and personal nurses, cosmetic surgery, and other highly expensive services?
Use the right comparison. What if the inefficiency in the U.S. health care system comes primarily from distortions caused by Medicare and Medicaid? How much of the inefficiency is caused by the the government?
Control for differences in legal systems. The U.S. spends more money on malpractice insurance due to differences in tort law between the U.S. and other countries. Are you going to eliminate malpractice suits in the government-run system? If so, could you achieve the same efficiency by simply reforming medical tort law as applied to private health care?
Account for the ‘free rider’ problem. The U.S. system encourages research and spending on new techniques and treatments. There are far more ‘early adopters’ of new treatments in the U.S. This is very expensive. Then when the procedures are perfected and the cost is driven down, other countries adopt them. The same goes for drugs - American consumers disproportionately pay the R&D cost of new drug development.
None of these are easy things to account for. But you can do better than just accept those loose correlations because they happen to bolster your argument. For example, instead of just comparing a gross measure like per-capita health care spending against another gross measure like life expectancy, how about comparing the total cost of say, diagnosing and treating a breast cancer patient in two countries, compared against the survival rate of those patients?
Another thing you can do to improve the statistics is to compare similar population cohorts. For example, Canada doesn’t have the big problems of inner-city violence and obesity that the U.S. does. So instead of comparing all of the U.S. to all of Canada, how about comparing Montana to Saskatchewan?
Or how about establishing a monetary value for waiting times, and adding that to the overall cost? Obviously, surgery you can get tomorrow is more valuable than surgery you have to wait a year for, if the surgery will correct a quality of life issue. But that cost difference is lost in comparisons that just account for dollars spent.