Would universal healthcare be more expensive or less than the current US system?

Great Debates
21

I don’t know about this competitiveness argument. Japan and Germany fund their health care essentially through employer contribution and employee copay, just as we do. And when they operate in the United States and turn a profit here (like with Bayer’s extensive American operations or plants making Japanese branded cars) they have to operate according to the same healthcare model American companies do - and they still do well.

Not that I don’t think changes can and should be made - but let’s recognize what costs and savings are out there and be realistic about them.

22

According to Healthcare in the United States - Wikipedia … uninsured people in the U.S. received approximately $35 billion in uncompensated care in 2001 … however … *various levels of government finance most uncompensated care, spending about $30.6 billion on payments and programs to serve the uninsured *

So, if I understand correctly, health care providers are not losing money. It is US taxpayer.

On another note, and maybe my question was not clear but, do you think that UHC and medical services cost regulation go hand-in-hand. At least that’s how it is in Canada - MD has to look up a goverment prescribed table where all services are listed and how much he/she can charge for it (well, yes, he’s charging the goverment, but still… it is listed).

23

When I’ve changed jobs, it hasn’t been a problem. If I was covered, I get coverage. Anything that existed under the old health care is covered under the new, which means that I can change jobs and health insurance and not worry about my SLE not being covered.

24

I love the free market. I have no problem with someone making a profit by figuring out how to provide better service at a better cost. I also think the United State should adopt a totally nationalized universal health care system.

The reason is that the free market fails utterly in this environment. A government run system will have the faults and inefficiencies that government run systems always have, but will be unlikely to match the train wreck that our “free market” system gives us.

The problem is that free market mechanisms work very poorly in the health context. The market is normally efficient because we can do comparison shopping and decide what product satisfies our own needs best given the cost. This works great for hamburgers and shovels and cars and houses, but not so well for insurance in general and terribly for health insurance. Insurance involves paying a fixed amount in exchange for a small probability of getting a large amount back when disaster strikes. It’s impossible to assess on the basis of our own experience or that of our friends whether any insurance plan is worthwhile because the payouts are so rare.

The situation is much worse with health care since the customers usually don’t even get to choose between competing insurance companies. Their employers do. The executives making the decision don’t base in on personal experience with the service but on price and superficial appearance of value. Then employees often get locked into their jobs because a change would jeopardize their coverage. This creates inflexibility in the job market, preventing people from shopping for the job they like best for the pay. With UHC they could move about freely, enhancing the virtues of a free labor market.

The reason socialism normally works so poorly is that people spend the government’s money on things they would never spend their own money on. The same works for insurance. When I went to get some auto body work done the first question was “are you insured?” Why? Because the price would be much higher if the insurance company was paying. I’ve seen auto glass replacement companies offer free steaks if you use their service (paid for by insurance). People are always figuring out a way to rip off insurance companies, legally and otherwise. Insurance can be thought of as privatized socialism. You pay a fixed amount and get back according to your need. A government run system won’t be any worse, and they can avoid advertising and marketing costs made necessary by competition. I expect the advantages of having a single universal system instead of many incompatible competing systems would result in a nationalized system being much more efficient.

While a few lonely old people and hypochondriacs may abuse the system, for the vast majority of us the last thing we want is health care we don’t need. Most of the abuse will come from doctors, hospitals, drug companies, and medical suppliers, just as they are doing now with insurance companies.

By almost any measure I’ve ever heard of, Americans get some of the worst medical care of any industrialized country (except, of course, for the very rich) and they pay more per person than anyplace else.

Unfortunately, even if we do pass some sort of universal health care package, it will no doubt be some sleazy deal that will kiss the butts of all the special interests and result in a huge kludge of non-standard competing systems. We need a clean sweep. Private health insurance should be eliminated entirely with the possible exception of some premium coverage for things that wouldn’t make sense of most of us.

25

You really want the government providing you with essentials like food, clothing, housing, transportation, etc? Cuba is the place for you then.

The fact is that a free market and competition have a much better record than government controlled industries. Much better.

Just look at the sheer ineficciency, waste and corruption which has been the reconstruction of Iraq.

Government-owned industries in Europe have been privatised in the last 25 years because they had become wasteful, inefficient and expensive. Europe has been privatising industries non-stop.

I am NOT arguing one side or the other of this case but your argument does not hold water. I would rather get my essentials from someone who stands to gain something by supplying me with them than from someone who has no incentive.

26

Really, as I said, I don’t want anyone but my doctor and I making this decision.

My plan, anything is “covered.” There’s no flip chart that says, “Whoops, NICE says we can only fix one eye, tough luck, bub.”

The difference is that when I am forced to save for my groceries I still only buy what I want. When I am forced to subsidize grocers, my demand for plantains is meaningless. The net result of you spending my money and me spending my money is not the same at all.

27

Yes - a glance at the pages of any financial paper at the moment shows that to be true. :rolleyes:

28

:stuck_out_tongue: Hilarious. And the really funny thing is…you didn’t mean this to be funny!

-XT

29

I think you do a disservice by describing the insurance game as free market - as you note, it is a rigged market and as such has hidden and skewed costs.

Actually, we do have a model for how medicine will behave in a pure free market - it is in those areas of medicine not covered by government or insurance coverage. And in these areas, we see that availability of care does broaden over time as costs radically go down.

Think of this when you hear an ad for cosmetic surgery or Lasik on the radio.

I am not so optimistic as to think that this can be broadly applied over the entire industry - but perhaps there are some lessons that can be learned here that can be. The high-deductable insurance paired with an HSA was a promising experiment here, but ran right into an insurance model with hidden costs that prevented its full implementation.

I’d love to see more transparency - the kind that comes out in radio ads for the surgical procedures I mentioned above should be the norm across the board.

30

You have no problem with “someone making a profit by figuring out how to provide better service at a better cost” and yet you would eliminate private health insurance? That is totally contradictory. Not to mention that no free country that I know of has eliminated private health insurance or private medical practice. There is no way in the world you could prohibit private medical practice or private insurance in America. No way in hell. You could not do it in Europe either.

31

:rolleyes: back at you until you show me a country with nationalised banking and major industries who is doing better over the decades than capitalist countries.

32

So in the USA if you have any form of health insurance you can have any treatment you want regardless of cost or efficiency, pre-existing conditions? Health insurers will happily pay for anything you want?

And NICE does not ‘ration’ it makes cost-benefit judgments on drug efficiency.

There is ‘rationing’ in the USA - the ability to pay and I’d be astonished if health insurers or providers never look at the bottom line when you are demanding a $20k a year drug that has a 5% efficiency.

33

Of course not. What I mean is, if you have the money for it, and you want it, then you get it.

This is rationing. I am not against rationing. There is no way to be against rationing. There are finite resources and practically infinite demands.

34

Army (well, military) health care is still free to all active-duty members and their dependents. It’s still bureaucratic as hell, although the bureaucracy is easier to navigate because there are representatives whose job it is to navigate it for you. It’s also easier to get a referral for civilian specialty care, so the wait times for appointments aren’t nearly as bad as they were, and the odds of having to travel to Washington for a doctor’s appointment are nonexistent. Reservists can buy into the system, although they’re required to use civilian doctors. When they’re activated, they must use military facilities, which leads to a loss of continuity of care. We’re pretty lucky, though, since the clinic we’re tied into offers pretty much all primary care services and the doctors are good about referrals to civilian doctors, so we haven’t had to worry about traveling to Andrews, Walter Reed, or Bethesda. Unfortunately, after-hours care involves a trip to the ER, so treating a 103-degree fever is expensive for the government.

Congressmen, senators, Supreme Court justices, and the President and his family are covered under the same insurance plans that all federal employees are offered. This was a campaign issue during the primaries last year when Elizabeth Edwards pointed out that, under McCain’s scheme, neither of them would be eligible for health insurance because of their histories of cancer, although both were covered under federal insurance.

I don’t think anyone’s arguing that at all, although compensation should be part of the discussion. Like any other profession, compensation should be commensurate with experience and education, not set so high that they’re priced out of the market, but high enough to be attractive.

Administrative costs are essential, although they could probably be trimmed back somewhat. Someone has to run the office. :slight_smile:

Robin

35

We are in the midst of the biggest financial crisis for a century. A crisis of capitalist greed. It doesn’t matter if others are not doing better. It’s all degrees of dreadful that removes any claim at all for lightly regulated free market economics.

But the example you are looking for is Sweden who solved their early 90’s problem through nationalising rather than bail-out and as a consequence their credit market has not dried up and they are much less exposed to the world crisis. A modest growth in 2010 GDP is forecast and a small fall this year.

Sweden offers lessons

36

Which in no way differs from the UK. You can buy any treatment you want if you can afford it with the added bonus that those without money can also get good treatment.

37

You’re right. What I was thinking was the the national plan should not include a specific role for private insurance and would replace the need for most of it. I’m certainly not for outlawing private insurance.

38

[quote=“Crocodiles_And_Boulevards, post:1, topic:487175”]

[li]Employer-provided insurance keeps people (like my uncle) in a job they don’t want.[/li][/quote]

I would think the opposite is more true. I am forced into whatever coverage my employer provides me. Which leads me to my second point…

Sorry but I don’t share your philosophy that turning a profit is necessarily a bad thing.

The problem is that there aren’t any market forces in place to increase competition and drive down costs. Employers decide on which HMO or insurance company they will use and the employees tend to be locked into a few choices based on what their employer decided.

39

Do you have private coverage? I do, and while the insurance statement tells me the cost, I am effectively shielded from it by a reasonably low co-pay. Given this, we should see lots of lots of unnecessary visits from people with good private insurance. Do we? If not, how would UHC be different? Please also cite the zillions of unnecessary visits in Canada and the UK.

40

True to a certain extent, though some employers offer a few choices. However the main point is that a person wanting to quit and start a small business is going to have to deal with a big jump in health care costs for him, and a big cost for his employees if he feels obligated to provide it. That depresses small business creation, and small businesses are a big driver of job growth. In this way UHC helps capitalism and competition, and that’s a good thing in my book.