Socialized Healthcare: Whats the big deal?

[Ferno]

Another point to consider is you can pay for socialized health care through your own plan, but you pay 50 bucks a month.

That's how we do it up here. Blue Cross, Alberta Health, BC Health, etc.

[Kilarin]

So the government is more of a switchboard than anything else - assigning blame and responsibility to relevant partys instead of footing the bill itself. Am i getting close to the cornerstone of Libertarianism? Or is this just absolute free market Capitalism?

Actually, many Libertarians DO believe in exactly that kind of government. I think that's taking it too far. I don't think it's unreasonable to ensure that cars have passed safety inspections BEFORE they get on the road, as opposed to suing some penniless guy after he causes an accident. And I think it's too risky by far to just sue people after they have gotten the entire city burned down. We must take reasonable precautions against people injuring each other through neglect.

Why is it that when the government raises taxes, this infringes on rights, but when an HMO denies necessary medical treatment to save a person's life, that is not a restriction of someone's rights?

Actually, I agree, assuming that the HMO contracted to cover that expense. Insurance companies are getting away with all kinds of activities that should be prosecuted by law, but aren't, because they have deeper pockets than the average citizen. I have NO PROBLEMS with the idea of forcing our government to force insurance companies to actually fulfill their contractual obligations.

I actually heard one insurance company begging for this once. Their complaint was that other insurance companies would drop customers as soon as they had a serious claim. The insurance guy said that was a violation of the basic contract, that you pay, and then if you have a problem, you are covered. And, he said his company didn't mind covering those kinds of expenses, but it was becoming very difficult to compete because all of the other companies were simply dropping the sick customers so that companies like his ended up having to pick them up. He said that he didn't want a lot of new insurance laws, he just wanted us to enforce the existing contract laws.

There's a dangerous myth afoot that only the government can take our rights away. However, the free market has an excellent track record for it itself. Wake up!

Surprise! I don't disagree with you! I just think that the government is even MORE dangerous than the free market. But I DO agree that the free market must have some controls. We have to enforce contracts, there must be some defenses against large monopolies developing and quashing all compatition, and a big company shouldn't be able to out spend you to victory in court.

The big difference between the government taking away your rights, and the free market taking away your rights, is this. IF the free market takes away your rights, you can always turn to the government for help. The government is SUPPOSED to be protecting against that kind of abuse. Not that they always fulfill thier roll, but when private citizens infringe upon your rights, the government is your safety net.

However, when the government gets out of control, you are just hosed. The only safety net is revolution, which IS built in to the US constitution, in both peacful and violent forms, But it's MUCH more difficult to get a out-of-control government back into control than it is to get an out of control free market back in control.

I simply reject that the role of the government is to protect people from each other.

If that is not one of the roles of government, what do you think IS the function of government?

why have police protection at all? I think it's obvious--simply, because police protection is good. But then why say that the government should only be interested in this one type of good, protecting people from each other? Why not famine relief or healthcare? These issues can carry more moral weight than something like police protection, so restricting it to protecting people from each other seems arbitrary.

there is a SERIOUS risk here in saying that the goal of government is to do "good" things. Who decides what is good? For example, I believe (and a LOT of people agree with me) that the use of alcohol, tobbaco, and recreational drugs are all very bad. That the world would be much better off without them. That all of our lives would be improved. I can prove beyond any shadow of a doubt that alcohol use causes an enormous amount of suffering in our society, not to mention expense. Same with Tobacco and drugs, but probably not as big an impact as alcohol.
So, it would be GOOD to stop everyone from using alcohol, tobbaco, and recreational drugs. So why not have the government enforce this rule?

Because the government shouldn't be deciding what is "good" for us outside of very limited areas. As soon as it starts doing so, it steps all over everyone. Many of you would be quite upset if prohibition came back, and, quite frankly, I agree with you.

The role of the government is to protect us from outside attack, and to defend us from each other. Anything outside of those two rules leads to abuse.

[Jeff250]

However, when the government gets out of control, you are just hosed. The only safety net is revolution, which IS built in to the US constitution, in both peacful and violent forms, But it's MUCH more difficult to get a out-of-control government back into control than it is to get an out of control free market back in control.

Do you see these as realistic fears to be concerned with to the extent that we should block government-provided healthcare because of them? It seems like you're looking at an extreme example of what might happen if we make a series of mistakes instead of looking at the consequences of just this decision.

If that is not one of the roles of government, what do you think IS the function of government?

It's not the role of government. I'll definitely acknowledge it as a role.

there is a SERIOUS risk here in saying that the goal of government is to do "good" things. Who decides what is good? For example, I believe (and a LOT of people agree with me) that the use of alcohol, tobbaco, and recreational drugs are all very bad.

First, do you have a competing theory as to why the government should provide police protection in the first place?

Second, we value people having the right to choose what to do, even when they make choices that are personally harmful to themselves, so long as it does not harm anyone else, i.e. allowing people the right to make these decisions is the greater good. So I'm not convinced that this is an effective counterexample. But certainly the government is in a better position to bring about some good things as opposed to others. For example, it's difficult for the government to try to curb child abuse, even though it's a noble pursuit, whereas it is easier for the government to provide famine relief.

[Kilarin]

Sorry for the long delay in my reply. Windows died on me again. Which will, in the long run, be a good thing because while I have my windows partition fixed and running again, I've learned to rely more heavily on Ubuntu. I'm only going to be using Windows for a very few programs now, and I'm trying to get those to work in wine. BUT, that all has nothing to do with the topic...

However, when the government gets out of control, you are just hosed. The only safety net is revolution, which IS built in to the US constitution, in both peacful and violent forms, But it's MUCH more difficult to get a out-of-control government back into control than it is to get an out of control free market back in control.

Do you see these as realistic fears to be concerned with to the extent that we should block government-provided healthcare because of them?

Yes. Look at how the government is spinning out of control in the US. It's growing and growing and growing, with no sign of slowing down or stopping, let alone going back.

For example:

But could America exist without an income tax? The idea seems radical, yet in truth America did just fine without a federal income tax for the first 126 years of her history. Prior to 1913, the government operated with revenues raised through tariffs, excise taxes, and property taxes, without ever touching a worker's paycheck. Even today, individual income taxes account for only approximately one-third of federal revenue. Eliminating one-third of the proposed 2007 budget would still leave federal spending at roughly $1.8 trillion-- a sum greater than the budget just 6 years ago in 2000! Does anyone seriously believe we could not find ways to cut spending back to 2000 levels? Perhaps the idea of an America without an income tax is not so radical after all. It’s something to think about this week as we approach April 15th.

<link>
The US government is swelling at an unprecedented rate, and it will continue to grab more power (and more money) unless the people INSIST that it stop. And right now what I mainly see is people asking for yet MORE government programs, and therefore more power in the governments hands.

And that IS what it is about, power. Right now, if your HMO cheats you (and they do, oh they do!) at least you have resource to the court system. When the government provides your health insurance and decides to cheat you, where do you turn for justice? The more power we hand over to the government, the less and less we have.

First, do you have a competing theory as to why the government should provide police protection in the first place?

By definition, a government must have laws, otherwise, what is it governing? And if you have no way to ENFORCE the laws, again, what are you governing? So a police force is REQUIRED for a government to exist, otherwise it's not a government, it's just anarchy.

there is a SERIOUS risk here in saying that the goal of government is to do "good" things. Who decides what is good? For example, I believe (and a LOT of people agree with me) that the use of alcohol, tobacco, and recreational drugs are all very bad.

Second, we value people having the right to choose what to do, even when they make choices that are personally harmful to themselves, so long as it does not harm anyone else, i.e. allowing people the right to make these decisions is the greater good. So I'm not convinced that this is an effective counterexample.

But I think this is EXACTLY the right example, for two reasons.

First, as you have said, we value allowing people to make their own choices. This includes the choice about how they want to spend money on healthcare. Once the government gets involved, you take away that choice because my money is taken to go to the government program whether I want to participate in it or not. Again, compare this to social security. Remember my previously mentioned example. If someone making $20,000 a year was allowed to INVEST that 15% of their income that the government steals for social security, they could retire with over half a million in the bank making $25,000 a year in interest. That's with VERY conservative, very safe investments. But since the government decided to "help" us with the social security system, we have retired people who are barely getting by and little old ladies living off of cat food. The governments help took AWAY peoples choices and power, and all in the name of providing something "good", protecting the elderly. When the government decides to "help" someone, you can usually tell the "helped" people by the hunted look on their faces.

Second, as I've stated before in this thread, once the state starts providing health care, how you take care of your health becomes VERY MUCH my business because it most definitely harms ME. Estimates indicate that smoking cost the US $96.7 billion a year in health care cost, both private and public. And just for the section that is public, each American household ALREADY spends $630 a year in federal and state taxes due to smoking. <link>

The amount of public health care we already have means that everyone's bad habits which SHOULD be none of my business, already are. Increase the amount the government is involved in providing health care and you will only increase this problem.

[Jeff250]

Sorry for the long delay in my reply. Windows died on me again. Which will, in the long run, be a good thing because while I have my windows partition fixed and running again, I've learned to rely more heavily on Ubuntu. I'm only going to be using Windows for a very few programs now, and I'm trying to get those to work in wine.

Good to hear!

Yes. Look at how the government is spinning out of control in the US. It's growing and growing and growing, with no sign of slowing down or stopping, let alone going back.

I don't see a government spinning out of control. I see a government that is largely responding to what we want. Your Ron Paul quote fails to address this. For example, if enough people want universal healthcare, then the government might provide it--but this is hardly an example of the government spinning out of control. What would be that is the government seizing power when no one wants it to. You'll find a lot of this in the executive branch these days, which is something to be concerned about, but I don't see the root of that problem as having anything to do with the government responding to issues of social justice.

And that IS what it is about, power. Right now, if your HMO cheats you (and they do, oh they do!) at least you have resource to the court system. When the government provides your health insurance and decides to cheat you, where do you turn for justice?

What are you imagining here? A government bureaucrat denying you treatment, by either accident or intent? Or some sort of sweeping government-wide conspiracy to deny you treatment? (The answers to and likelihoods of each are going to be different.)

I'm not only concerned about when HMO's legally cheat people anyways. As you said, that is largely a matter for the courts. I'm also concerned about when the HMO legally cheats you. What is your recourse then? What about when life decides to cheat you--what is your recourse then?

By definition, a government must have laws, otherwise, what is it governing? And if you have no way to ENFORCE the laws, again, what are you governing? So a police force is REQUIRED for a government to exist, otherwise it's not a government, it's just anarchy.

I don't see how we can gain understanding about what the government should do or not do by looking at the definitions of words. If the definition of government included that it provided universal healthcare, I don't suspect that this would close the case for you. You would suggest that we need to reevaluate the definition of government.

[Kilarin]

I don't see a government spinning out of control. I see a government that is largely responding to what we want.

Valid point, allow me to rephrase that: I see a government that is growing larger and larger, more powerful, and more cumbersome, and, as a result, less effective. I agree that, unfortunately, this seems to be what the public wants, or at least what they are voting for. Democracies seem to inevitably self destruct this way.

Think of the government as a pet dog. The dog may be too fat, not because the dog is stealing food, but because people in the household are feeding it to much. This doesn't change the fact that the dog is too fat. And it's quite right for people with SENSE who live in that house to complain that the others should quit feeding the dog so much. Besides, this dog can bite, and the fatter it gets, the grumpier it's going to get when you try to cut back on it's food.

What would be that is the government seizing power when no one wants it to. You'll find a lot of this in the executive branch these days, which is something to be concerned about

I agree that it's something to be concerned about, but I disagree that no one wants it. You see that people are voting for more government programs, so that must be the peoples will, but you don't see that people knowingly voted for George Bush KNOWING and DESIRING that he would grab more power for the executive branch.

Right now, G. W. Bush is experiencing a big drop in popularity, but I can STILL find conservatives who not only approve of the executive power grab, but wish it would go further. And while it is true that the majority of Americans did NOT vote for Bush the first time around, a majority of them DID the second time. And when they voted then, they voted knowing full well what G. W. was doing. He had already been doing it for 4 years. Many of them have changed there minds since then, but they still got what they voted for.

The executive power grab is JUST as much the fault of the voters of this nation as is the increase in government programs.

A government bureaucrat denying you treatment, by either accident or intent? Or some sort of sweeping government-wide conspiracy to deny you treatment? (The answers to and likelihoods of each are going to be different.)

Both. Have you seen the nightmare that Medicare/Medicaid is? Just do a google on (medicare OR medicaid) cuts.
If you want to see how fair and good socialized medicine would be, take a look at the complaints about the medical treatment vets get.

This is one of the central issues of the entire socialized medicine thing. Why do people think that medical care would be cheaper if you pay for it in taxes than cash? Because you WILL still pay for it. They will take it out of your pocket in taxes, then blow most of it on internal waste, steal a big hunk, and deal out whatever is left as stingily and inefficiently as possible. that's the way government works. Again, please take a look at the Social Security system and tell me if you think the citizens of the US are getting a good deal?

And why do people think that government bureaucrats will care more about your personal well being than corporate bureaucrats will? Every day the government takes away the property of private citizens through "eminent domain". Sometimes they do it for the greater good, to build roads, dams, etc. But frequently they take it for frivolous reasons. The local government took away some property my church owned so they could build a GOLF COURSE. And even worse, they actually take away one private citizens property so they can give it to another private citizen or corporation. Check out this story for a particularly disgusting case. So why does eminent domain continue to exist when most people agree it's wrong? Because it doesn't hurt MOST of us, and we like shopping malls and golf courses. So we may whine a bit, but we don't INSIST that they treat the minority who are affected by this fairly.

And that's what I expect to happen in Socialized Health Care. If you don't belong to a large voting block, you will get the short end of the stick.

What about when life decides to cheat you--what is your recourse then?

when life cheats you, you are just hosed. And there isn't a thing the government can do to fix that.

[Pandora]

I haven't read all of this thread, so apologigies if I restate things that already have been said and dealt with.

This is one of the central issues of the entire socialized medicine thing. Why do people think that medical care would be cheaper if you pay for it in taxes than cash? Because you WILL still pay for it.

Of course you - and everyone - will pay. The great advantage of socialized healthcare is NOT that the AVERAGE spending for healthcare is reduced, but that it is more evenly distributed. Everyone pays a bit more as he would need if he stayed averagely healthy. The surplus can then be used to help those to whom something really terrible happens. Otherwise, such a event might not only cripple them for life, but also leave them with debts that they could never pay off.

What this is is usually called "reciprocal altruism". It is supposed to be one of the foundations of all successful societies. I accept a small disadvantage (a small tax) to help you out a big deal (immense hospital costs). We both win, because I can expect the same if the situation was reversed.

They will take it out of your pocket in taxes, then blow most of it on internal waste, steal a big hunk, and deal out whatever is left as stingily and inefficiently as possible. that's the way government works. Again, please take a look at the Social Security system and tell me if you think the citizens of the US are getting a good deal?

Ah, but that is not an argument against socialized healthcare. That is an argument for more efficient government interventions. It implies that socialized healthcare might be a good thing, if only the government could implement it efficiently. Would you agree with that?

[Pandora]

argh -- i hit quote instead edit. sorry!

[Testiculese]

I don't agree. I haven't been to the hospital in 30 years. Why should I be paying for all these fatass smokers killing themselves slowly? Or the welfare mom with 15 kids? Why would I want my money wasted on these people?

You're taking responsibility away from the people for their own actions...look how poorly that has turned out so far.

(This is all besides the fact that if hospitals weren't raping the insurance companies in wholesale fraud, hospital costs woulnd't be half of what they are now)

[Jeff250]

when life cheats you, you are just hosed. And there isn't a thing the government can do to fix that.

Unless you're meaning "fix" in a sense like "completely solve 100%," I don't understand how you can possibly justify this statement. (And if you do mean "fix" as in "completely solve 100%," then why dwell on it not being 100%?)

One case where the government tries to make up for life's little injustices is in disaster relief. Here the government provides, through no contract or legal obligation, relief to people who have suffered terrible disasters. Of course, I don't think I need to lecture you about this, as I'm sure you're already quite aware. But, even though it's not 100% successful, it's way better than nothing at all. So please tell me what you mean by that when life cheats somebody, that person is hosed and the government cannot fix it, because there's a lot the government can and does do.

Or the welfare mom with 15 kids?

I never thought that this one was compelling. Is it the kids' fault that they were born into a welfare family?

[Kilarin]

The great advantage of socialized healthcare is NOT that the AVERAGE spending for healthcare is reduced, but that it is more evenly distributed.

The result of socialized retirement benefits is that the poor people, who need it the most, have the 15% of their income that they sorely need taken from them and then stolen so that there is little (or in the future possibly NOTHING) left for their retirement. Meanwhile, the rich can afford to lose the 15%, and in many cases, never pay it at all, and make other arrangements for their retirement.

Socialized medicine will result in the poor paying more for less care, and the rich bypassing the system and getting the best care anyway.

What this is is usually called "reciprocal altruism".

I believe strongly in helping others. I donate to charities that I have determined are actually doing the best job of getting benefits to those who are actually in need. What makes me angry is that putting this in the hands of the government doesn't mean I'll suddenly start helping my fellow man when I wasn't before. What it means is that I'll have less money to give where it actually helps, while a lot more of my money gets eaten up in government bureaucracy and never helps anyone at all.

That is an argument for more efficient government interventions. It implies that socialized healthcare might be a good thing, if only the government could implement it efficiently. Would you agree with that?

Can you come up with a single instance of a government program that has been implemented efficiently? It is the NATURE of government that it is a bureaucracy. Never have the government do anything that you can get any other way because the government will ALWAYS do the job inefficiently.

This is all besides the fact that if hospitals weren't raping the insurance companies in wholesale fraud, hospital costs wouldn't be half of what they are now

Indeed. And the fraud is coming from three directions. The hospitals cheat the insurance companies. The insurance companies cheat the hospitals. And the people cheat both.

This is what happens when you have extra middle men. A system that would eliminate this would be nationwide implementation of a reasonable medical savings account system. One that every citizen could have access to. You would pay in a monthly fee, and most of that fee would simply go into the account, from that account you pay your medical bills, direct to the doctor or hospital. No middle man. A small percentage of the fee goes to purchase a high deductible umbrella insurance policy that covers in case you have some disaster that exhaust your savings account.

Now the reason this system will work so well is two fold. In the first place you eliminate the middle man for most medical expenses. People dealing directly with doctors and hospitals will save the doctors and hospitals paperwork, AND will force doctors and hospitals to try and be competitive, because when I am paying the bills myself, I'm going to shop around a bit.

The other reason this will work is that people are, on average, healthiest while they are young. If you don't spend all of the money in your medical savings account in one year, you let it roll over to the next year. As the savings account grows larger, you can keep increasing the deductible on the umbrella policy and therefore decreasing the amount of money that isn't going directly into your saving account. A few generally healthy years and young people could build up a substantial savings fund to cover most medical expenses, while still resting comfortable knowing that if they have a disastrous illness, the umbrella policy will kick in.

It's a system that could work. Unlike giving it to the government. That will just cause poor people to get even worse health care because it gives them even less control over their health care costs.

when life cheats you, you are just hosed. And there isn't a thing the government can do to fix that.

Unless you're meaning "fix" in a sense like "completely solve 100%," I don't understand how you can possibly justify this statement.

There are very few problems that the government can fix at all. And I wouldn't classify most of them as being in the category of "when life cheats you". BUT, thats a very fuzzy category, so you may have a different definition and your mileage may vary.

But in particular:

One case where the government tries to make up for life's little injustices is in disaster relief. Here the government provides, through no contract or legal obligation, relief to people who have suffered terrible disasters

And they do a lousy job at it. So lousy that they have even REALIZED that they are lousy at it and started hiring private firms to do it for them. (which doesn't always fix the problem)

Just to point out what happens when you rely upon the government for such things as disaster relief, lets look at a small example that happened to my own parents.

They had a HUGE oak tree in the front yard. GIGANTIC. A mini tornado came through, ripped it out of the ground and threw it back down. Thank goodness it missed the house. So over all, my folks were really lucky. But, in the meantime, they've got this huge tree in pieces all over their front yard. Now in previous years when tornados had hit and ripped huge paths of destruction across the state, the government stepped in and helped with the cleanup effort. They sent out trucks to pick up rubble and men with chainsaws to help cut it into manageable hunks. But the tornado that hit my folks only hit about three houses. So the city announced that it did not qualify as a "disaster". NOT because the damage it did to those houses wasn't significant, but because there just weren't ENOUGH of them to qualify as a disaster. It could have wiped their homes to the ground and it wouldn't have qualified as a disaster since there were only three of them.

So, did they get any help from the city in cleaning up? Nope. Instead they got a notification that if the mess in the front yard was not cleared up in two days, the city would fine them.

The same problem happens all the time on larger scales. On one side of the line its a disaster and you get federal assistance. Houses destroyed on the other side of this imaginary line don't count and you are on your own. On a daily basis, if your house burns down, don't expect help from the government. But if 30 peoples houses burn down, then they might fork over some funds.
Of course, I fail so see how it make any difference to YOU whether your house was destroyed alone, or along with several of your neighbors. Either way, you are out a house.

I believe strongly in helping people. I contribute regularly to a group that provides disaster relief around the world. I just want my money to go where most of my dollar will actually end up HELPING people instead of padding the pockets of government bureaucrats and politicians.

[Testiculese]

Or the welfare mom with 15 kids?

I never thought that this one was compelling. Is it the kids' fault that they were born into a welfare family?

No, but it's not mine either. She wouldn't be having them if she knew she couldn't afford them. I can't afford a litter. Therefore I don't have a half-dozen future McDonalds employees. She can't either, but she's not responsible for herself. They are paid for with no effort on her part. Socialism makes me responsible for her and her children. I have enough problems of my own, thanks. I don't need to be saddled with hers too.

[Jeff250]

Just to point out what happens when you rely upon the government for such things as disaster relief, lets look at a small example that happened to my own parents.

I'm sympathetic, but really, your anecdote does a better job of demonstrating why the government should provide more complete disaster relief, if your parents did not meet the current qualifications. It's also a far cry from demonstrating that the government is useless for helping anyone, since the very thing that makes your anecdote significant is that it is an exception.

No, but it's not mine either. She wouldn't be having them if she knew she couldn't afford them. I can't afford a litter. Therefore I don't have a half-dozen future McDonalds employees. She can't either, but she's not responsible for herself. They are paid for with no effort on her part. Socialism makes me responsible for her and her children. I have enough problems of my own, thanks. I don't need to be saddled with hers too.

Again, we shouldn't be concentrating on her problems, since she is largely culpable here--she deserves what she gets. But we should be concerned with her childrens' problems. I'm sure that if you were born as one of her children, you'd have a different point of view. But since you weren't, you shouldn't care?

What this comes down to is a matter of justice and a matter of ethics. Being born in destitute poverty is an injustice. Being born in a starving third-world country is injustice. And when people die of hunger, that's evil. (Unfortunately, the church has watered down words like "evil" to include things like two teens having sex in the back of a car or to include homosexual unions, but don't let that dissuade us from thinking that evil exists.)

I find Rawl's Original Position thought experiment to be most compelling here. Imagine yourself to be designing a society behind a veil of ignorance where you know nothing about who you will be, including which family you will be born into and their class, your religion, your ethnicity, your gender, your sexual orientation, your skills or handicaps, and so on. What kind of society are you going to design? Rawls says that people in that kind of position would select two principles of justice. The first is that everyone would have an extensive set of basic liberties. The second is that there would be no social or economic inequalities unless it benefits the least privileged members of society and unless any position is fairly available to everyone. In other words, a doctor might be paid more money, but only so that more people would go through medical school to become a doctor. Rawls thought that since people did not know if they were going to be born poor or stupid or disabled, they would opt for his principles of justice, which largely compensate for these injustices.

This is also related to the idea of reciprocal altruism that Pandora brought up, at least insofar as we put ourselves behind the veil of ignorance.

[Pandora]

"The result of socialized retirement benefits is that the poor people, who need it the most, have the 15% of their income that they sorely need taken from them and then stolen so that there is little (or in the future possibly NOTHING) left for their retirement. Meanwhile, the rich can afford to lose the 15%, and in many cases, never pay it at all, and make other arrangements for their retirement.

I don't agree. I lived in two countries with socialized health care so far. I come from a quite poor family, and I can honestly say that without socialized healthcare we would have been a lot worse off. We can afford the little bit of tax increase, but paying for the hospital bills would just have ruined us.

edit: also consider that the *really* poor people are usually exempt from paying the tax.

moved my second edit to the post below because it overlapped with Kilarin's next post...

[Kilarin]

since the very thing that makes your anecdote significant is that it is an exception.

but its NOT the exception. That's the problem. Every day people suffer disasters that destroy their homes. Fire, storm, whatever. These people don't get help from the government because they weren't in an official disaster area.

Are you saying you want a government that attempts to "help" every one of these people?

without socialized healthcare we would have been a lot worse off. We can afford the little bit of tax increase, but paying for the hospital bills would just have ruined us.
edit: also consider that the *really* poor people are usually exempt from paying the tax.

Your point is valid. People at the bottom of our system right now might find lousy government health care better than no private health care. But I feel that is in a large part do to how sick we've let our healthcare system become.

I've got a friend who's job was to manage an entire team of people who tried to collect health insurance for a small group of doctors. The health insurance companies, of course, have matching teams who's job is to attempt to deny payment to the doctors. Every time you pay your doctors bill you are paying for BOTH of these teams.

I do not deny that our health care system is VERY ill, I just don't believe that putting it into the hands of the government will fix it. Inefficiency, middlemen, corruption, bureaucracy, and red tape are what is messing up our health care system. These are all things that the government magnifies, not fixes. Again, look at medicare and medicaid. That's what we'll be getting MORE of if we let the government handle health care.

The way to correct the health care system is to actually fixing the problems the health care system has, not to add new ones.

[Pandora]

"The result of socialized retirement benefits is that the poor people, who need it the most, have the 15% of their income that they sorely need taken from them and then stolen so that there is little (or in the future possibly NOTHING) left for their retirement. Meanwhile, the rich can afford to lose the 15%, and in many cases, never pay it at all, and make other arrangements for their retirement.

something to add to my post above, because I am slow on the uptake today: paying a (low) percentage of their income particularly benefits the poor. They have a low income and therefore will also pay only little for health insurance. If the poor get private health insurance they would have to pay the full price. Conversely, the fixed prices of private health insurance are beneficial for the rich, because a fixed deduction becomes neglible the higher the income, but is practically non-affordable if you don't earn enough. So, in fact, socialized health care is the only way the poor can get quality health insurance.

edit: this was written at the same time as your post above, so it might have a bit of overlapping content.

[Pandora]

[Your point is valid. People at the bottom of our system right now might find lousy government health care better than no private health care. But I feel that is in a large part do to how sick we've let our healthcare system become.

I think the german socialized healthcare was excellent, in fact. The benefits for poor people matched the benefits of most high-cost private insurances. But it is in trouble now, and many of its benefits are cut down now. The UK health healthcare system is much more basic, but still gets all the important things done. You know that you will be cared for if something bad happens, even though the tax is really small.

I've got a friend who's job was to manage an entire team of people who tried to collect health insurance for a small group of doctors. The health insurance companies, of course, have matching teams who's job is to attempt to deny payment to the doctors. Every time you pay your doctors bill you are paying for BOTH of these teams.

Ouch, that's bad. I think something like this occurs more with private healthcare, though. I have never heard of something like that in the two socialized healthcare systems I have lived in. There are usually fixed rules about what is covered (e.g. pregnancy, broken bones) and what is not (glasses, dentistry).

[Ford Prefect]

I do not deny that our health care system is VERY ill, I just don't believe that putting it into the hands of the government will fix it. Inefficiency, middlemen, corruption, bureaucracy, and red tape are what is messing up our health care system.

Yes something is not working properly in the U.S. healthcare system all right. Given that it operates on a competitive basis with various hospitals and HMOs vying for customers you would think that this would drive the cost of health care down compared to monolithic systems such as Canada and Britain. Yet the over all cost of health care in the U.S. is about 21% of GDP as opposed to 17% in Canada an a miserly 11% in Britain. What is going wrong? How is it that U.S. doctors and hospitals seem to have a monopoly on serving the ill that allows them to charge above the expected rate?
In systems like Canada's there is only one health insurance company (the government) and so they call the shots, if an area only needs one MRI to serve the population then there is only one MRI funded. If it only takes 1000 acute care beds to provide care then there are only 1000 beds. The government is the monopoly and the doctors end up earning less than their U.S. counterparts. But in the Capitalist system an oversupply of hospitals and MRI machines such as there is in some parts of the U.S. should drive the price down but this doesn't seem to happen.
I travel a lot in the U.S. on business and I am always amazed at the amount of advertising of health care services that goes on. Seems like every other ad is for a hospital or HMO (the other half are offering cheap credit or bankruptcy protection). Advertising=competition=lower prices in the usual economic model but not in health care in the U.S. for some reason.
Seems like a system that behaves differently from the standard model may need an non-standard solution.

[Testiculese]

You know, I might have a different view if the government as it stands today didn't consider me an ATM machine.

Considering I already pay 60% of my income in taxes, I don't really see how losing any more of my money is a good thing. I love to help people, but I can't afford it if the government is in charge of it.

But still, her children are not my problem. People lose, more often than not. She should have learned from her parent's mistakes. She's an idiot for having a raft of kids by as many fathers. Her kids are lucky they aren't in some other places on this planet. I pity them, but they are just a dozen or so in a sea of millions of kids who's parents should never be parents. Why should their bad decisions have to impact me?

[Testiculese]

Ford, the problem lies in the fact that the doctors started realizing they can charge that little bit extra because the insurance company picks up most of the tab. \"Oh let's do this [wholly unnecessary test (if they even did said test)] too.\" That was 25 years ago. The doctors/hospitals have increased that 'little bit' to 'a complete ★■◆● load'. Now when you don't have insurance, you get charged the insurance rates because if they charged you what is normal, the 'scam' is uncovered. But realize that the scam works on both ends because the insurance companies can lobby to government, buy some politicians, and get laws that insure a steady income, and then raise premiums by a fea % and regenerate billions over what the 'health industry' collects. It's win-win for the doctors, hospitals, and insurance company. The loser? You! Hahaha.

Anyway, that's why.

[Ford Prefect]

This might be a relevant story. My neighbours, Arlene and Rory, took their 3 year old daughter on a camping trip from Richmond B.C. to Whidby Island in Washington State. One morning they found the little girl's left eye swollen almost shut. Concerned they took her to a clinic where the doctor told them she had a serious infection and that the safest course was to check her into hospital for intravenous antibiotic treatment. Naturally alarmed they took her to the nearest hospital for a second opinion and the emergency ward doctor there agree that a week in hospital on intravenous was the best course. They decided to pack up and take the 2 hour drive back to Richmond so she could be in hospital near home and also because the Canadian medical system would only pay for the cost of treatment in Canada not the difference to the more expensive hospital time in the U.S.
At the emergency ward in Richmond the doctor examined the little girl, pointed to the mark on her lower eyelid and told them she was having an allergic reaction to a bug bite and that she would be just fine without treatment. And she was.
The U.S. doctors may have been concerned about liability for medical malpractice but the Canadian doctor faces the same laws in Canada. The U.S. doctors do however make extra money, as does the company they work for, by increasing the level of treatment of patients. And who makes a better health consumer that a pair of loving parents? The Canadian doctor is paid only for the examination and has no stake in the earnings of the hospital.
So I say that for-profit health care has some serious flaws. Not that flaws are lacking in the Canadian system as well.

[Ford Prefect]

Stupid forum debug warning.

[Kilarin]

yeah, stupid debug error. So I'll make this as short as possible:

I AGREE that our current system is seriously flawed. The whole idea of the insurance middle man is NOT working anymore. You won't get any argument from me on that point.

But going to socialized medicine just puts a different middleman in place. And one that is then much harder to get rid of. We HAVE socialized medicine systems in the U.S., Medicare and Medicaid, not to mention the entire Vet system. And they are full of red tape, corruption, inefficiency, and abuse.

We need a solution that removes the middle man, not one that just replaces the current middle man with another.

[roid]

that's a fine story Ford-Prefect. Apt advice for everyone to have at least some basic medical know-how

[Testiculese]

Here's the other reason healthcare should not be socialized

[Kilarin]

David Walker, Comptroller General of the United States.
http://www.youtube.com/watch?v=KGpY2hw7ao8

He says that the U.S. is nearing complete fiscal collapse. And that the biggest problem is Medicare and Medicaid. Specifically, that you could eliminate the pentagon and military budgets entirely and it will hardly even make a dent in the troubles ahead. Mr. Walker says that Social Security is indeed a terrible mess, but it's not even CLOSE to the problems Medicare and Medicaid are facing.

The 60 minutes staff says that almost no one disagrees with Mr. Walkers numbers.

[TIGERassault]

Here's the other reason healthcare should not be socialized

I don't see how that's relevant.

[Testiculese]

Really? I would be paying for these fatass's healthcare because they can't stop stuffing their faces with Hot Pockets and cupcakes.

Do you not understand the implications of being that fat at such an early age? Chronic heart problems. Diabetes. High blood pressure. Asthma. All this before the kid's 18.

I'm supposed to pay for this?

[Dakatsu]

Mr. Walker says that Social Security is indeed a terrible mess, but it's not even CLOSE to the problems Medicare and Medicaid are facing.

Since Medicare provides healthcare to the Elderly and Medicaid provides healthcare to the Poor, wouldn't universal health care wipe away medicare/medicaid?

Really? I would be paying for these fatass's healthcare because they can't stop stuffing their faces with Hot Pockets and cupcakes.

Do you not understand the implications of being that fat at such an early age? Chronic heart problems. Diabetes. High blood pressure. Asthma. All this before the kid's 18.

I'm supposed to pay for this?

Technically your paying for others fire and police protection, why should I (well, my parents) have to pay to protect you?

Also, you are already paying for the elderly and poor peoples health care (Medicare/Medicaid) so you are already paying for poor fatasses and elderly who need meds.

[TIGERassault]

Really? I would be paying for these fatass's healthcare because they can't stop stuffing their faces with Hot Pockets and cupcakes.

Do you not understand the implications of being that fat at such an early age? Chronic heart problems. Diabetes. High blood pressure. Asthma. All this before the kid's 18.

I'm supposed to pay for this?

I take it then that you don't ever plan on having children?

[Testiculese]

My kids won't be eating the garbage that I see in other people's cabinets. They would get 3 meals a day. Meats(mostly white), fruits/vegetables, and juices. (With treats like KFC on occasion of course...)
There will not be cases of soda, fake, processed boxed food and candy and chocolate everywhere. No fast food three times a week.

Guess what? $10 says my kids won't be fat.

---

I am paying for MY police and fire protection. Your parents are paying for THEIR police and fire protection.


Where are your arguments here?

[Kilarin]

Mr. Walker says that Social Security is indeed a terrible mess, but it's not even CLOSE to the problems Medicare and Medicaid are facing.

Since Medicare provides healthcare to the Elderly and Medicaid provides healthcare to the Poor, wouldn't universal health care wipe away medicare/medicaid?

Well, yes. But thats like saying that we can't afford the payment on our $200,000 dollar house, but since we are going to buy a million dollar house it doesn't matter.

Our current experiments on socialized healthcare, Medicare and Medicaid, are in such incredibly bad condition that the chief accountant for the U.S. Government thinks that they will send this country under if something is not done about them soon. And if you watched the vid you will notice that both right-wing and left-wing think tanks agree with him. It's not a political issue, it's just math.

[Dakatsu]

Mr. Walker says that Social Security is indeed a terrible mess, but it's not even CLOSE to the problems Medicare and Medicaid are facing.

Since Medicare provides healthcare to the Elderly and Medicaid provides healthcare to the Poor, wouldn't universal health care wipe away medicare/medicaid?

Well, yes. But thats like saying that we can't afford the payment on our $200,000 dollar house, but since we are going to buy a million dollar house it doesn't matter.

Whoops, meant to write into my other post: "Granted, socialized healthcare would cost more than those programs"

Our current experiments on socialized healthcare, Medicare and Medicaid, are in such incredibly bad condition that the chief accountant for the U.S. Government thinks that they will send this country under if something is not done about them soon. And if you watched the vid you will notice that both right-wing and left-wing think tanks agree with him. It's not a political issue, it's just math.

I personally think we need a system that just isn't laced with lots of crap. It is possible, government doesn't automatically waste money, it does it due to ineffiency.

Heres a question: Assuming we could fund this without taking away more from your income taxes (as to how, I don't know, but lets say adding 1% to all sales taxes) would you approve of a SocMed program?

[Ford Prefect]

U.S. military budget 2007 $399 billion
Medicare cost for 2004 $230.9 billion
Medicaid cost for 2004 $295 billion (approx 60/40 share fed/state

So federal medicare/medicaid cost $407.9 billion (2004)
Federal military costs $399 billion (2007)

Specifically, that you could eliminate the pentagon and military budgets entirely and it will hardly even make a dent in the troubles ahead.

I don't agree.

Military spending estimate from http://mibi.deviantart.com/art/Death-and-Taxes-9410862
Medicare/medicaid costs from Wikipedia

[Kilarin]

...government doesn't automatically waste money, it does it due to ineffiency.

Are you aware of any government program that isn't run inefficiently?

Heres a question: Assuming we could fund this without taking away more from your income taxes (as to how, I don't know, but lets say adding 1% to all sales taxes) would you approve of a SocMed program?

No. See my answer to the above. Government is inherently inefficient, and government grows. The first US Income tax was a simple 3% system. It grew. Government programs almost always do. And as they grow, the become more and more inefficient.

Also, I still maintain that socialized medicine greatly increases the likelihood of further government interference in our lives. Look at Testiculese's complaints about overweight children. As soon as we have a socialized medical system, the government will have every right, and actually, even a DUTY to try and keep the health care costs down. This could EASILY lead to all kinds of crazy government programs to monitor peoples weight, treating alcohol and tobacco with the same crazy laws that we use on drugs now, etc. A socialized medicine program is going to cost a major hunk of the budget, to reduce those expenses they will almost inevitably start interfering in our personal choices.

Specifically, that you could eliminate the pentagon and military budgets entirely and it will hardly even make a dent in the troubles ahead.

So federal medicare/medicaid cost $407.9 billion (2004)
Federal military costs $399 billion (2007)
I don't agree.

Those are current numbers. What Mr. Walker is discussing is what's going to happen in the very near future when the baby boomers hit retirement age and suddenly go on Medicare/Medicaid. We are about to see a very large portion of our population suddenly go onto socialized medicine. We don't have the money to pay for it.

[Pandora]

Also, I still maintain that socialized medicine greatly increases the likelihood of further government interference in our lives. Look at Testiculese's complaints about overweight children. As soon as we have a socialized medical system, the government will have every right, and actually, even a DUTY to try and keep the health care costs down. This could EASILY lead to all kinds of crazy government programs to monitor peoples weight, treating alcohol and tobacco with the same crazy laws that we use on drugs now, etc. A socialized medicine program is going to cost a major hunk of the budget, to reduce those expenses they will almost inevitably start interfering in our personal choices.

That is a very good point. This is exactly what happened in both Germany and the UK. However, i think the interventions I have seen so far were rarely very radical. The most radical thing was the smoking ban introduced in the UK, and that refers only to smoking in public indoor places (e.g. pubs) and brings the UK basically to the same level as most parts of the U.S. Unless I am missing something, the other efforts to bring health costs down consisted mostly in the dissemination of information.

[Pandora]

Regarding the rising costs of US healthcare: i am not so sure if these spiralling costs are not partically *because* healthcare in the US is mainly privatized. In a privatized system, the health insurance companies have an interest in rising medicine costs: the more expensive it is to become ill, the more scary is the thought of paying these costs, and people are more likely to get an insurance that will cover it. This is aggravated because the companies can raise their insurance costs independently of one another. Therefore, spiralling costs can go undetected for longer, and there is no central authority that can exert pressure to reduce costs.

In contrast, in countries in which socialized healthcare, rising medicinal costs lead to much more prominent tax increases. The deals between medicine providers and health insurance are well publicised and raises are quite apparent. Moreoover, the government has an incentive to put pressure on the medicine providers to keep the costs down, and can provide an upper limit to how high the costs can go.

[Ford Prefect]

Kilarin- You don't think military spending is going to rise?
Health care is more like sewage disposal than groceries. Competition in grocery supplies keeps the price down. Competition in sewage disposal systems fractures the grid and makes it inefficient. Imagine three or four sewage drains running under your street so you could chose the lowest cost provider from month to month. Health care has the power of monopoly on the wrong party. When you or your kid are sick or injured you can't negotiate levels of care and brands of equipment. You have to use what is available. As Pandora points out putting the monopoly on the government as the sole consumer allows more control of the cost. As evidence: the cost of health care is a greater proportion of GDP in the U.S. than in countries with centralized health care insurance. The benefit has been proved out already. The people of the U.S. are just unwilling to pay taxes for anything, health care included. As I have said before. The wealthiest nation in the world will not give up any of it's wealth to a just health care system. Sad but true that the citizens of the U.S. put personal gain ahead of public good. Testi is a fine example of this. I simply don't believe his claim to 60% of his income going to taxes unless he has a 9 figure income and an idiot for an accountant. Tax freedom day in Canada, which has a higher overall tax rate than the U.S. is usually mid-June. That is the date where the average income earner has paid all their taxes, income, property, utility, sales... the usual list. That is just over 50%.

[Kilarin]

i am not so sure if these spiralling costs are not partically *because* healthcare in the US is mainly privatized. In a privatized system, the health insurance companies have an interest in rising medicine costs:

I agree, but it's not a problem with it being privatized, it's a problem with having a middle man between you and the medical system. The current insurance model doesn't work well with capitalism. More on this below.

the government has an incentive to put pressure on the medicine providers to keep the costs down, and can provide an upper limit to how high the costs can go.

Yes, and they also have an incentive to reduce benefits to the small percentage of people that cost the most to maintain. It's the same problem we have with insurance.

You don't think military spending is going to rise?

Valid point. But if the democrats get in charge and withdraw from Iraq, military spending is likely to go down a bit. Whereas, when the babyboomers hit medicare, we are going to see unbelievable increases in the expenses of that program.

When you or your kid are sick or injured you can't negotiate levels of care and brands of equipment. You have to use what is available.

This only applies to emergency care. For most situations I can and DO pick medical care facilities based on service and price. Not that it helps a whole lot since insurance gets between us anyway.

As evidence: the cost of health care is a greater proportion of GDP in the U.S. than in countries with centralized health care insurance. The benefit has been proved out already.

http://www.cato.org/pubs/catosletter/ca ... erv3n1.pdf
This article by John Goodman from the CATO institute makes some very fine points. He disputes the idea that healthcare is better in Europe or Canada than in the U.S. And points out that while we do spend more, we also get more bang for our buck.

And his determination of the major problem matches with what I have been saying here:

WHAT'S MISSING IS CAPITALISM: While our health care system is more market-oriented than in most industrialized nations, we don't really have a free market in health care in the United States. Half the spending is done by government. Most of the rest is done by bureaucratic institutions. The cosmetic surgery market is about the only market where patients are really spending their own money. And guess what? It works like a real market. People get package prices. They can compare prices. And over the decade of the 1990s, the average price of cosmetic surgery actually went down in real terms, even as there were all kinds of technological innovations that we are told drive up costs elsewhere.

As long as we have middlemen paying for the majority of healthcare, corruption, inefficiency, and prices will all continue to go up.

Why do these systems overprovide to the healthy and underprovide to the sick? Well, in the United States, about 4 percent of the patients spend half the money. If you're a politician allocating health care dollars, you cannot afford to spend half your money on 4 percent of the voters--4 percent who may be too sick to go to the polls and vote for you anyway. Why is the hospital sector so inefficient? Because it's in the self-interest of hospital managers to be inefficient. The chronic care patients and the empty beds are the cheap beds. It's the acute care patients that cost money. Why can the rich and powerful jump to the head of the waiting lines? Because those are the people who control the system. They can change the system. If members of parliament, the wealthy, and the powerful had to wait for care along with everyone else, these systems would not last for a minute

Our system has major problems. Putting the government in charge of it will just make them worse.

The people of the U.S. are just unwilling to pay taxes for anything... Testi is a fine example of this. I simply don't believe his claim to 60% of his income going to taxes unless he has a 9 figure income and an idiot for an accountant.

The people of the U.S. pay taxes to support artist who's art consists of throwing elephant dung at a painting of the Madonna <link>.

The income tax rate for a person single with no kids making average U.S. salary is 29.1% <link>
That is JUST income tax.

Social Security steals another 12.4%, that puts us up to 41.5%. (yes, yes, your paycheck will show 6.2% for FICA OASDI, but that is just a fictional number. You pay half, the employer pays half, and you can bet your boots the employer figures that 6.2% into the amount of money they can afford to pay you as a salary, so it's actually 12.4%)

FICA Medicare is 1.45%, so now we are up to 42.95%

Now I see from his profile that Testiculese is from Pennsylvania. I found this information on their local taxes:
Personal Income Taxes: Flat rate of 3.07%
State Sales Tax: 6% Other taxing entities may add up to 1%.
Gasoline Tax: 32.2 cents/gallon

The income tax is easy to add in, that puts us up to 46.02%. now that is JUST the base taxes on his income. He will pay 6% state income tax on everything he purchases at a local store, and probably 7%. He'll pay taxes to license his car, and depending on how much he drives, possibly a LOT of taxes on gasoline. He will pay property tax. If he is renting, the property tax is indirect, but he's still paying it. Will all of these add up to another 13.98% of his income? I don't know, but it's not that much of a stretch. And to me, 46.02% seems mighty big all by itself.

[Pandora]

I agree, but it's not a problem with it being privatized, it's a problem with having a middle man between you and the medical system. The current insurance model doesn't work well with capitalism.

How do you imagine a health insurance system without a middleman? Here in the UK, we have a hybrid system that I like very much. There is basic (and compulsory) health insurance that cover's the basic needs of a person. AFAIK this is only a small part of your taxes. People can then top it up by going to private health insurance companies, or they can get insurance DIRECTLY at the instituation that also renders the service --- sort of like a subscription for a certain doctor. However, at the moment, this latter system is mostly realized for sub-sectors of health care, like dentistry and optometricians (sp?). But would this be roughly what you have in mind when you talk about a system without a middleman?