Universal Healthcare

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When I was in the United States training in the Japanese language for my missionary service, I met a highly obnoxious little pile of excrement named . . . I'll call him J. J. used the term "socialized medicine" in reference to my Canadian system of universal health care in the same tone that I would use the term "dog humper". I'd never seen such vitriol spewed against my country, not to mention against a system I thought had a lot going for it and wasn't immoral at all.

The Obama thread has spurred me onto this topic in that I am curious as to what SPers think of government funded health insurance. I like the concept, but I am able to see the positions of its detractors. Here's what I think their beefs are -- correct me if I'm wrong:

1: A universal health care system forces clean-living, hard working people to pay the health costs of addicts, fools and lazy people. In an ideal world people work hard and take care of themselves, and go to their family, friends, religious groups and / or charitable organizations in times of trouble. They should not go to the government.

2: A universal health care system almost requires the government to step in and regulate prices for medical services and drugs, which is anathema to the free market approach to economics. Only the open market should decide prices.

3: Because addicts and other people are such a drain on any health system, the government may intrude on their rights -- most of us have no trouble with the government interfering in the lives of those who use illegal drugs, but is it possible the government would start telling us how to eat so that it can cut down on the obesity, heart disease, diabetes and other negatives that accompany poor diets?

4: Government cannot run businesses as well as the private sector. Efficiency and the quality of medical care will suffer.

I see the last part of #3 being very unlikely, and I find #4 laughable in that the free market has hardly generated a system that provides high quality service to the entire population. But what say you, my friends? Is health care a right? In a system like Canada's, what services should be listed and what services should be excluded? Is J.'s opinion shared by a lot of Americans?

 

1. They are forced to do that anyway, that or completely deny them care and letting them die.

2. I much prefer to do this than to have multinational corporations completely exploit the pain and suffering of sick people.

3. They already do that in parts of the US with the special taxes or was it even a ban on transfats in NY.

4. I think you gave a pretty good answer to this one yourself. Whether a company or organisation is publically owned or private seems to have very little to do with whether it is run well or not.

These are my rebuttals to these points, I know that these weren't your points LKD.

 

To be honest, Joacqin, I think my American friend J. would have seriously considered that to be a valid option -- survival of the fittest and all. A position, I might add, that is quite antithetical to my faith and left me wondering what planet he was really from. I would like to believe that most Americans don't think this way but some days I wonder -- and fear.

 

Actually I think the biggest concern of a socialized medical system like Canada has is the decrease in high quality people going in to (and staying in) medicine. As the government regulates the medical industry it will also regulate the pay of medical professionals.

Quality of health care is often directly proportional to the pay allowed for the medical professionals (not just doctors). Perhaps I'm wrong, but that is my impression and the number of people from around the world coming to the US for expert medical care seems to support this opinion.

 

The view I've always had is that the system in Canada is acceptable and does most things well, but it is underfunded and the waiting list for important procedures is long. If you are a Canadian with lotsa $$ then going to the US and jumping the queue is a really tantalizing option, though is costs you an arm and a leg. I'd hazard a lot of people with the $ come from all over the world to the US.

But what about the poor living IN the US? Or even the middle class who just cannot afford important care options? I feel that they have the right to life-saving operations and shouldn't suffer just because of a lack of funds.

But I'm not saying the quality of care in the US is poor -- far from it, if you can afford it it's the bom diggity.

 

A very good point. No matter how we organize the system, we will be rationing health care. The big question we need to be asking ourselves is how such care should be rationed. Should we ration care based on need and without consideration for the patient's ability to pay, or should we use a pay by service or insurance-based model? There are, of course, numerous options lying within this spectrum as well. I happen to like the system as it is set up in Germany. Insurance is mandated and the government offers a policy, but individuals are free to choose a private carrier (however, only 15% of Germans elect to do this). For those who cannot afford coverage, the government either subsidizes it or provides it outright. Doctors can still run their own practices, insurance companies are still able to operate, and everyone is insured (or at least they're supposed to be).

Health care costs are strangling American businesses on the world market (since their competitors don't have to deal with such costs) and the costs of treating the uninsured when their untreated minor conditions become life/limb threatening major conditions is driving up everyone's medical costs*. The hospitals pass those costs on the their cash customers and insurance companies, who pass the costs on to the public. Either way, the public is already paying for the uninsured.

* I doubt I even need to mention how much cheaper preventative care is than last-ditch treatment, or that our nation's collective health care costs would likely go down with a single payer (or near-single payer) solution. I will nevertheless concede that the start-up costs will suck.

 

I love this argument.

I'm disabled, unable to work and atheistic. I can't rely on friends or family that much.

And apparently most of these people think I should die for it.

 

I think it would be more apt to say that most of those people are so disconnected from reality that the holes in their ideological stance don't even occur to them, but I appreciate the sentiment nonetheless. I doubt you'll be hearing a whole lot of "the system works fine as it is" arguments here on the boards. We won't all agree on exactly what needs to be fixed or how, but I firmly doubt that there are too many people around here who think that nothing whatsoever needs to be done.

 

I've always thought that the US would be better with something like the NHS that we have in the UK. Everyone gets access to vital medical treatment, prescription charges are regulated and if you want to jump the queue then you can do by being treated privately.

Regarding prescription charges, anyone who has to get a lot of prescriptions in a year has the option of paying £104 (I think, not sure if that's the right amount) and that covers them for every prescription that they need. Also, pregnant women, children under 18, the elderly and those out of work are given free prescriptions.

When I was a nurse working in a mental health ward I saw a lot of people who were in desperate need of help who wouldn't have managed at all in a system where you need health insurance. A lot of these people had no family and were incapable of doing the basics to look after themselves, let alone organise health insurance

 

the thing is, universal health care doesn't mean private hospitals can't exist, so the rich can still jump the queue and get "better" treatment faster.

 

Beyond even that, what Doctors can expect to get for their services is already being regulated...by insurance companies. No matter what type of solution we employ, what a Doctor can charge for his services is always going to be regulated by someone.

 

The first point is not so much whether there is the money. People are sick and will be sick and treating them does already and will in the future cost money. The question is at what price.

Nobody here said it, but you get to hear that from some hardcore conservatives in the US: I find it hard to tell someone that he won't get life saving surgery because it costs too much, because the US is at war and has a huge deficit, and anyway, he could have privately taken care of his health problems. Considering that the costs of treating cancer can easily eat up a family's retirement 401 or other funds, that's a little brazen a statement.

And the idea that the free market is always more economical is flawed by the aspect that the market is only more economical because it is for profit. Inefficiency costs money. So do profits.

When competing with a non profit organisation the private company perhaps, there is no guarantee for that, will be more efficient. That doesn't mean their offer will be cheaper. It is interested in being cheap enough to get the offer. They will never be as cheap as they can get, because they need to make profit. That's why they are economical; they turn the savings into profits. That doesn't mean that the consumer will benefit from that increase in efficiency through a lower price. There also is no guarantee that a company will reinvest it's profits into investments for the future, like in infrastructure. They might just save the money and have higher profits.

Famously (and probably over simplified), Californian energy companies, providing the formerly public service of electricity supply, never invested their profits back into infrastructure; they even capped production and shut down power plants to artificially inflate the price while providing less energy. They put the money not spent on infrastructure and production into profits, and, exacerbated by massive speculation, the result became known as the California electricity crisis.

It is imo relatively easier to control graft in public service through oversight by elected and publicly accountable bodies than in a private company which has a right on keeping their data private.

That means that imo there is no reason why dedicated public servants cannot be as efficient as or more efficient than the private sector and have lower costs, and also let the consumer benefit from the money saved on profits. That approach would be quite adequate in the health care sector. It is not a question of no choice or a dual choice between public service or privatisation but merely of sound managerial practices.

 

A timely New Yorker article. Turns out that the spirit of entreuprenialism and the spirit of, um, healing the sick are...not necessarily in alignment.

 

Well... kinda common sense, really. Businesses exist to make money, after all.

What has been more surprising imo is that many surveys show that the US spends a higher percentage of its GDP on healthcare than most other countries - including those such as Germany or France that have practically universal coverage. Off the top of my head, the last two spend around or slightly less than 12% of their GDP, the US was around 15. Considering that it also has less people being serviced, the difference is imo staggering. Why isn't that taken into account whenever anyone talks about efficiency?

 

Actually, you hear this in the talking points from people on the left all the time.

 

The problem with government regulated health care is that, well, it's government regulated and, governments make the modern health care system in the US, even as messed up as it is, look like rank amateurs when it comes to messing up, running over, and flat-out corruption. Just imagine how much we'd be rolling in the ailes if your average US Congressman started talking about the inefficiency and corruption of modern medicine. Talk about the pet calling the kettle black!

In all seriousness, though, looking world-wide, the lesson we have to learn is that government regulated health care entirely depends on the government regulating it. Some have taken it to ridiculous extremes, some have effectively killed their own medical system, and some have actually done a nice job of working things so the average consumer is helped. Now take a look at how the US government typically does things, and tell me if you want them setting up your health-care system.

 

And the average American citizen spends more out of pocket per year on healthcare than the average German or French citizen. I saw an article earlier this year that added up the cost of what each person pays on average, in different countries for healthcare. They included all healthcare related expeneses: what you pay for insurance, copays, prescriptions, hospital fees, and taxes that go to healthcare. The report said that the average American pays almost $2900* annually for healthcare costs. Not only was that the highest in the world, but it was nearly double what the next highest total was. (I'm not positive, but I think that Germany ranked second on the list at a little over $1500 per person.)

The thing is, that same report ranked quality of care that you receive. If you paid the most, but got the best treatement, you could at least say that you could see where your money was going. Unfortunately, the US ranked 16th in terms of quality of care. If an argument against government run healthcare is lack of efficiency, it seems like the system is already pretty damn inefficient the way it is, when you spend the most but don't get the best (or frankly nowhere near the best) quality.

* This seems like an entirely reasonable figure to me. I have a family of three, and I spend nearly $4500 per year on insurance alone. I am spending that much money just to have the ability to go to a doctor or a hospital. But I still have out of pocket fees for prescriptions, hospital visits, doctors, vaccinations, and we still haven't calculated in how much I pay into Medicare or Medicaid (1.45% of my salary I believe) that also could be considered a health care related expense.

 

I do hope you realize, Taza, that this extremist view is not my position. I will, however, point out that

a) many charitable groups are non-religious in nature and

b) many if not most of the religious ones will provide aid for people regardless of their opinions on religion.

An extremely good point. I'd rep you for this if I could.

 

Oooh Yes! Definitely! I'd love to have them in charge instead of our lot. We're not picky, we'll take whichever politicians ye want to get rid of.

Of course if I had a choice I'd much prefer to have a German/Swedish/Finnish/etc. government fix our health system. But US would do.

 

Averages means that extremes may tweak things. The US has some truely top-notch medical institutions, as proven by the number of people that come here not just from Africa or Mexico, but from Japan, France, Canada, etc. for expensive, delicate, and dangerous medical procedures. These facilities cost through the nose, but they're worth it. Unfortunately, we also have some that are just bad, and I mean really bad, and prices are still high, just not as high.