Universal Healthcare

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IMHO what hampers the implementation of universal health care in the United States and to a lesser degree Canada is not a practical issue, but rather an ideological one. Western North American culture values the "rugged individual" and firmly believes in the individuals right to determine his own cours in life and also his responsibility to take take of himself. As such the individual should take care of his own health needs and leave other people alone. In addition, we are loathe to dictate too much to others (that is to say, doctors) how much money they are allowed to make -- they studied quite hard to qualify, so they should get lotsa $$ in return) so we don't want to regulate their prices too closely. We fear that if we do they will go elsewhere where they can make more money.

I'm not saying that these positions are right, but I think they do exist and form part of the baseline of opposition to the introduction of European models of health care.

 

Wait a second, Canada does NOT have UHC?

 

We do, though the "universal" part is always under debate. And the idea of "two tier" medicine is always raising its ugly head and sparking debate, the idea being that if people opt out of using the regular health system and choose to pay for their own care, all the good doctors will flock to the "second tier" and the poor will get doctors who got their licences from cereal boxes.

Also, there are those who quail at the idea of the universal health care system paying (with taxpayer dollars) for obviously stupid procedures that should be elective, expecialy when there are people with truly life threatening conditions who are waiting.

 

Approximately a third of private insurers' spending is on administrative costs. Government run care? The percentage is much lower. By, like, a factor of ten.

 

There are horrible amounts of red tape in large corporations. There are so many layers of management that it is often impossible to keep track of the latest "company initiative." But there's really little point, because you know that next week there will be a new one anyway. All these layers of management are self-supporting, and are really fairly useless in the overall scheme of things. I'm sure it's not much better in government, but it can't be much worse.

 

Chandos, you'd be shocked. In government, the new initiative is to create more levels of middle management! Seriously, though, no one has the potential to screw things up like the Government does, and that's largely because of pointing fingers, pointless red tape, mindless rules made by people with neither knowledge nor stakes in the system, endless committees, and more.

 

Sorry, I'm not buying it. I worked for too many large corporations to believe that government is worse. What you are describing is exactly how most corporations "work." The big difference is that government is held accountable by the people; corporations are largely not held accoumtable to anyone. They just disappear, like how Enron and Circuit City did.

 

Consider the nature of the insurance industry. Every claim paid reduces profit. The insurer therefore has incentive to avoid paying claims, or to reduce the claims paid as much as possible.

I'm not an expert by an means, but that's my suspicion.

I realize I didn't post any links to hard facts, but dude. You're wrong. Thirty seconds with google, that's all you need.

Here, for starters.

And yes, that is less than 1/3. Note that California's insurance industry has Kaiser, which is actually pretty damn good--certainly better than the average, nationally--and is also mostly not-for-profit.

 

I like Ron Paul. He's a boon to the US. Despite my probably numerous disagreements with Dr. Paul, I like him more the more I learn about him.

While he is as hardcore a libertarian - Austrian school of economics for that - and staunchly conservative (literally; not the Rush Limbaugh variant), he has what many on the right imo lack - and that is a lot of common sense and reason as far as matters of purity of ideology is concerned. Excellent interview:

Probably because he has been a practising physician he is one of the few in the health care debate who really knows what he is talking about and who is familiar with the financial situation of his patients.

I read that he when he was practising in Brazoria County his practice refused big carriers like Medicare and Medicaid payments. Instead Paul worked pro bono, arranged discounted or with custom payment plans for patients in need. He is aware of poor patients being unable to pay him. He has his ideals and views, but he knows need when he sees it. He probably knows that while he might be able and willing to afford the altruism of working pro bono for poor patients, many of his colleagues won't or don't.

He captures one point extremely well. When I hear the O'Reillys, Becks or Limbaughs on healthcare they babble and blather about socialism and liberals seeing health care as a right. That all misses a fundamental point that Paul sees quite clearly when he says: "you don’t want to cut under these [economic] conditions medical care from poor people who have been dependent, or the elderly. It is not about a right or about socialism, but about decent treatment of people in need. It is a moral issue and an issue of medical ethics. It is something your heart can bleed for.

The babblers and blatherers don't get that or don't care beyond the point of making political hay from it.

 

Ron Paul is a great person to listend to. I don't agree with him 100% either, but he's one of the few politicians I've heard that actually applies common sense to his policies (as opposed to his political maneuvering).

 

I liked this opinion piece from http://www.fivethirtyeight.com/ I spoilered the part I like, the link goes to the site with all of the other articles.

Spoiler

 

Ron Paul has struck a huge cord with liberals, mostly because he despises many of GWB's policies, such of the war in Iraq, the use of torture and the violations of civil rights. His views on these issues made him an outcast of the Republican Party in 2008. The party hoped to silence his opposition, since he refused to march lock-step with the Republican Base. Instead, RP was given an outlet through the liberal media (Rachel Maddow and The Daily Show, where he has become something of a regular).

I'm sure all the liberal attention surprised him (although he seems delighted by it). I've followed RP for the last 25 years since his district is close to Houston. Nevertheless, he is not a liberal. He is a straight-up Barry Goldwater conservative, the kind of conservative that many modern "consevatives" run away from as fast as they can. RP really believes in limited government and a balanced federal budget, even when Republicans are in power (not only when Democrats are the ones in power). Many modern consevatives claim that Goldwater lost his groove as he got older.

Take a look:

Quite amazing. Following Goldwater's policial career is almost a mircocosm of how the conservative universe has evolved over the last 50 years.

http://en.wikipedia.org/wiki/Barry_Goldwater

Ron Paul is also the author of several interesting books.

http://www.sorcerers.net/shop/1_100...dom-Peace-Commerce-and-Honest-Friendship.html

 

If this is true, it's stunning:

Why VA Health Care is Better than Yours

And what's Howard Dean doing on Countdown?

 

So, according to Yahoo, Obama's team might have gotten the Blue Dogs back in the kennel... but at what cost? For one thing, hardcore liberals won't like it too much.

Here is what the new compromise bill may have if this story turns out to be correct:

- A tax on high-cost insurance plans
- lower federal subsidies designed to help lower-income families,
- exempt additional* businesses from a requirement to offer insurance to their workers and change the terms of a government insurance option.
- instead of a public plan or plans - "non-profit cooperatives that could operate at the state, regional or even national level. "

So much for it being Obamacare I think the Blue Dogs might be doing more to sabotage a meaningful reform than the Republicans ever could.

*additional? Who else was exempt?

 

That's the Senate version - the House version does have a public option. To me, if you don't have either a public option OR a personal mandate, you don't have universal health care.

 

I think some of the health funds in Germany were managed by non-state actors... Ragusa, can you help us here?

edit: I came across that (http://www.pbs.org/moyers/journal/07102009/potter_testimony.html) a while ago and... wow. That is just sick. Isn't it just so convenient that the rumors of a compromise bill leave out just what the witness so strongly advocated?

 

I'm not watching the video because Olbermann is damnably annoying, but: probably relevant.

FWIW, I checked out the sources and citations a while back when I cited this on another forum, and they were all in line.

 

Hmm, so we have an article from January 2005 praising the reform of the VA from the late 90's, using information mostly from 2003 and before. Incidentally, the VA administration was at that time pressured to allow for more private actors (as per here). The next several years there are ongoing complaints that the VA funding (at a period the US is involved in its most serious conflict since Vietnam) is insufficient. In 2007, we get the Walter Reed scandal and with it cries about the poor quality VA offers (and I'm not sure WR was one of the VA hospitals itself - I think it was a private one "subcontracted" by the VA).

It is possible that this is all purely coincidental and not at all related, but I think it is quite likely these events are linked by the same idea - that the dogma of the "free market" superiority should be upheld and enforced, regardless of the facts encountered. The same idea is very much alive now.

 

I was with you up until this conclusion. You lost me there. It seems to me that the move from the '90s woes to the '07 woes is, if anything, proof that both systems (free market and government run) can mess up just as badly (actually, I think the gov't run system was worse, but not by much).

As to the actual progress of the VA, I think the lesson is simple: Everything's easier when there are fewer demands. Sure, they were doing terribly until they reformed, but that's because they hadn't reformed since WWII or so. The gov't system was a waste because it was too rigid when things were lax, whereas the free-market system cut corners when things were tight.