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Tuesday, April 15, 2008
“Universal Health Care”
Ever since the start of the presidential campaign -- back around December 2004, wasn't it? -- there's been a lot of chatter about "universal health care." The phrase has figured prominently not only in the curriculum vitae of Mrs. William Clinton, junior United States Senator from New York, but in her stump speeches and press statements as well. And of course the junior senator from Illinois, B. Hussein Obama, has made some noises about it too.
Your Curmudgeon has only a single question about this admirable-sounding goal: What do you mean by it, please?
Each of the three words in that phrase is ambiguous of import. Jammed together as they are, they make for a good round thumping phrase, just the sort of thing a liberal politician uses to bring the crowd to its feet. Yet the meaning of the whole is even less than the sum of the meanings of its parts.
The least uncertain of the three is "universal." That means "everywhere," right? Or since we're dealing with a political promise, perhaps "everyone." Either way, it's a grandiose ambition; no one in history has ever succeeded at bringing any identifiable thing to everyone. If you doubt this, try to name a good or service enjoyed by all Americans, under uniform conditions of access. Yes, price matters; no good thing can be had by anyone without someone first meeting its price. No, "political rights" won't qualify either; not one of them is unrestricted in availability. The "right to life" is denied to persons convicted of a capital crime; the "right to liberty" is denied absolutely to convicted felons and, depending on their occupations, contextually to nearly everyone else; the right to "pursue happiness" is devoid of meaning.
Then there's "health," one of the Benedict Arnolds of our discourse. Are you healthy, Gentle Reader? How long would you stay that way, given the normal progression of events? How about in a world devoid of maleficent microorganisms and traffic accidents? With medical intervention, or without it? Good health is merely the slowest rate at which one can die.
Finally we come to "care." What constitutes "care" in this context? However healthy you may be, imagine yourself sick. What constitutes care depends on the disease and its severity, no? Is "care" required to make you well, to prolong your life by some span, or just to alleviate your pain between now and your last breath? As we've already noted, regardless of which objective you specify for your "care," there'll be a price on it, possibly a high one.
Your Curmudgeon has been sidling up toward a number of provocative questions:
- Should health care really be "universal?" That is, should the identity, habits, and character of the subject have no bearing whatsoever on the sort of medical care he can demand as a right?
- Should health care be understood so stringently as this: whatever is required to return the patient to a condition of perfect health -- ? What about self-inflicted injuries, genetic defects, and lifestyle-related diseases? What about conditions for which only palliatives exist? What about health deficiencies incurred through contributory negligence; for example, lung cancer, which is strongly correlated with smoking?
- Should the price of health care ever enter into the decision whether or not to render it? Price is an indication of difficulty, of resources required, and of opportunities forgeone. $1 million spent to save one man from death by AIDS might mean that ten persons cannot be saved from their brain tumors, or a hundred persons might be denied the drugs that would cure their diptheria. No purse is infinitely deep; choices of this sort will be made by someone.
- What about the impact of medical treatments? If two persons await equally costly medical procedures but only one can be treated with the resources available, does it matter which one will benefit more? For that matter, what of the terminal patient whom nothing can save, but whose life can be extended by a few more weeks or months by an excruciatingly expensive regimen? Every dollar spent on him is a dollar unavailable for treating persons who might be restored to "perfect health." Given that his condition will inevitably and foreseeably kill him, ought we to squander resources on him that might do more good if applied to others?
Worst of all the aspects of the health-care controversy is the insistence, mostly by liberals but gaining increasing acceptance among conservatives as well, that health care should be considered a right. In that view, to deny a man the medical goods and services he demands is to commit a felony against him. Rights are absolute; they make no room for considerations of better or worse. If a man has a right to life, then we may not kill him, no matter what good we might imagine would flow from his demise. If a man has a right to his property, we may not take it from him without his consent, no matter what worthy projects we might undertake if it were ours rather than his.
If a man has a right to health care, then no matter how sick he is, nor how he got that way, nor what our medical science can do for him, nor how imminent his demise, nor how treating him would deprive others, he must be granted that which he seeks.
Perhaps you've pondered some of these questions before this, Gentle Reader. They're but a few of the thorns that festoon the universal-health-care thicket,. They won't go away simply by making government the agency that answers them. Indeed, politicizing health care -- turning it into a right -- will only guarantee that the favor of politicians, bureaucrats, and persons with the ability to influence them will trump any other consideration.
Food for thought.
Comments
If it goes the way it has up here in Canada, then your government-run “right to health care” will transmute into the right to a spot on a waiting list. Rationing is the inevitable outcome of “universal” anything.
There is a glimmer of hope: recently a Canadian court (in Quebec, if I’m not mistaken) ruled that being on a waiting list is not the same as receiving health care. We’ll see.
Posted by on 04/16/2008 at 12:41 AMIn my humble opinion, playing a word game over the meaning of “universal health care” is not the issue. The issue is that the US ranks 37th in health care quality among industrialized nations and first in expense. What is being proposed is a means to bring the health care system in the US to a state where we actually receive the best health care for the buck. We are woefully off the mark there compared to many other western industrialized nations. If you don’t believe me, get sick.
People who are healthy and who rarely need health care may not realize just how drastically their lives can change with catastrophic onset of conditions such as AIDS, cancer,stroke, heart disease or even accidents. Those who oppose providing universal health care often have the means of paying their own way or they have very good insurance. Those who do not have those privileges often have to prioritize their medical care into a list that includes other basic needs such as shelter and food. Parents forced to choose between providing a roof over their kids’ heads or getting their healthcare....well, what would you do?
How can we expect to compete longterm in a worldwide market where the basic needs for health care in 36 other industrialized nations are provided for their citizens? When 40+ million of our citizens can’t get or can’t afford insurance, isn’t it reasonable to assume that their health will suffer as a result? If 40+ million of our citizens are worrying about what will happen if they fall ill and can no longer provide for themselves or their dependents, isn’t our nation is at a disadvantage compared to all other western nations.
Perhaps I have my priorities out of whack. I could be worrying about someone’s shoe addiction instead of worrying that my fellow Americans have the best health care that they can get for their money. Thirty-six other nations surpass us now. Let’s go shoe shopping, honey!
Posted by Ron Hudson on 04/16/2008 at 01:25 AMYou know, Ron, I was willing to give you the benefit of the doubt—not stupid, not evil, just a fellow whose hypertrophied compassion lobe has eclipsed his think-it-through center—until that last paragraph. That was pure venomous contempt. It makes it clear that you deserve special treatment, and that’s what you’re going to get.
Keep an eye on Eternity Road, Ron. You’re about to become one of its featured items. Oh, and that 37th-in-the-world-in-health-care bit? If you have a reference for that, e-mail it to me; the address is on the left side of the page. I’ll bet it could use a little scrutiny, of a sort you’d be disinclined to give it.
Posted by on 04/16/2008 at 05:40 AMI’d like to take a minute to say that I take great offense at Mr. Ron Hudson’s remarks, so much so that I’m not sure I’ll be able to put it into words. But I’ll try.
Here’s the thing:
My wife and I want to have children very, very badly. There’s a little problem. Her health.
While we aren’t an especially wealthy married couple by any stretch of the imagination we do have decent health insurance. It allows her to see her doctors on a regular basis and it has even allowed us to seek help this past year from a Reproductive Endocrinologist and an IVF center. It has given us a great deal of hope we havn’t had in a long time. You might see us as lucky, fortunate. Trust me, we are not.We both work very, very hard to be able to afford this. We have shopped around, not only for insurance but for careers that let us afford what we need and want.
Why should my wife and I be responsible for others, as well as oursleves? Because that is what it will amount to. More taxes for her and I.
Why aren’t these ‘40+ million’ self-interested enough to do more than whine? Why not seek solutions? We have, inspite of sickness and infertility, a great, though not materially wealthy, life together.
It offends me, Mr. Hudson for you to use such numbers to imply that my wife and I are lucky or privileged or both. We are not. Every time I hear the arguments that you and your ilk vomit forth you insult the people who take action.
And inviting the same people who brought you Social Security, Social Welfare and the IRS (All ‘paragons’ of efficiency and accountability) to take control of the life my wife and I have carved out terrifies me. Will they decide the world needs no more children and deny us coverage to for infertility treatments? Or will they deny someone else?
While our current system if rife with problems, one thing still exists and that’s the freedom to go elsewhere: Get a new job. Find a different insurance carrier. Work harder or longer or both. Own up to one’s choices.
Posted by Jim Sullivan on 04/16/2008 at 07:41 AMhttp://www.photius.com/rankings/healthranks.html
That is from the World Health Organization. I had a post from ABC News that showed similar results, but the link has timed-out and is no longer available. Sorry. I tried. Perhaps you can search the ABC New archives for articles about the state of health care in the US.
I am a “little” sorry for the shoe shopping comment as well. I found it funny that you listed shoe shopping as a priority in your sidebar and was trying to show you that I read your site and know you have a sense of humor too.
For Mr. Sullivan, Universal health care does not have to take away choices for those who can still afford choice. In the UK, for example, the nation provides health care for all. If you have income you want to put toward a special need and the system isn’t working for you in the way you want, you can still buy private insurance and have access to the doctors and clinics you want.
It is all about how the system is built and as an American, I know that we can do better and build a system that works for all Americans. Just because the perception is there that we have a government system in disrepair (and I would tend to agree with you after the last 8 years), that does not mean that we as a nation can not persevere and improve. If France, Italy and even Andorra can do it, why can’t we?
If you have health issues, you will find that even here, we have waiting lists. You have to get an appointment to see a nephrologist? We may have an appointment open in 2 months. If it is an emergency and you need immediate treatment, then that is a different situation and you will find that you might wait in the ED/ER for a while until seen. Did you know that at least 4 people died in South Carolina last year awaiting access to medications for HIV/AIDS? We have no safety net for life-threatening illnesses in this country. Some people can not work and have no support system such as family to fall back upon. “Go to work, get a better job” is just not a universally humane response.
I am looking forward to what you have to say. I will check back and look forward to engaging in a good discussion of options that we must face up eventually. I see caring for us all as a nation as an issue of ethics and doing what is right. If every life that is conceived is sacred, then how can we not care for those who need care after they are born?
Posted by Ron Hudson on 04/16/2008 at 10:57 AMPlenty of those 40+ million aren’t citizens, citizen. Many of those that are probably dont’ *need* coverage, either--I didn’t when I was, say, 20.
Also, what’s the standard of comparison? Industrialized nations where babies can be euthanized without the parent’s consent if the doctor thinks the baby will have a poor quality of life? Or those where people are dropped from the list for surgery after 6 months, because of a bureaucratic demand that waiting lists not exceed 6 months? I refuse to take that “37th place” at face value.
Posted by on 04/16/2008 at 10:59 AMI have posted links here, Rick, before your comment appeared. I haven’t seen them show up yet, but some of the answers are there. If you want to do your own research, just google “health care rank by country”, “infant mortality by country”, “life expectancy by country” or any other health care related issue by country and see what you find.
Which country are you referencing that euthanizes babies? I can tell you from the list in front of me if it outranks us. I can not imagine that the WHO would condone such activity.
Also, which country drops you from the surgery list? I am primarily referencing countries (G8 and other “western” countries) that share the same economic and social values that we place on ourselves. If you do the google search, you will see the list.
Again, from one of my other posts this morning, we have the ability to influence how the system is built. I know that Americans have the ingenuity and ability to make it work in a way that would meet the needs of the majority of its citizens. Just because something is not working well right now doesn’t mean that it can’t be improved.
Posted by Ron Hudson on 04/16/2008 at 12:05 PMIt seems to me that the problem we have with health care in the US is largely regulatory. We make it very costly and difficult to create primary care doctors, while their profit margins are much lower than specialists (who cost not much more to train). The result is that the supply of primary care doctors cannot grow as fast as the population grows. We burden all doctors and hospitals with massive amounts of paperwork and tasks for political reasons (from requiring doctors who perform abortions to do ultrasounds (Oklahoma)) to filling out forms disclosing every contact they have with drug companies. Then, on top of all that, our “insurance” system does not generally provide insurance, so much as cost sharing, and it is based around large corporations. As a result, there is little incentive to seek low-cost alternatives to high-cost care, even when low-cost alternatives are as effective.
Every health care system “reform” I have seen to date would exacerbate these problems, rather than reduce them, especially those that shift the decision making focal point from doctors and patients to bureaucrats. And from friends in Canada and England, and the stories they tell, I wouldn’t trade health systems for anything. (Neglect, denial of treatment for non-medical reasons, and the normal run of crap that comes from dealing with any government bureaucracy make getting good care for anything other than primary care a hit or miss proposition at best.)
Posted by Jeff Medcalf on 04/16/2008 at 01:13 PMMr. Hudson said
“For Mr. Sullivan, Universal health care does not have to take away choices for those who can still afford choice. In the UK, for example, the nation provides health care for all. If you have income you want to put toward a special need and the system isn’t working for you in the way you want, you can still buy private insurance and have access to the doctors and clinics you want.”Mr. Hudson, you are missing the point entirely! I am like the previous poster. i have worked my butt off my entire life to provide for my family and make sure that they were insured, even funding that insurance out of my own pocket when the need arose due to layoff. I am not some “wealthy elitist” I am a person who chose to take his and his family’s destiny into his own hands, instead of whining about how the gubbmint isn’t taking care of my health care needs.
What you just said about the England-style health care would not apply to me. What would happen inthis situation is that the VERY GOOD health care that I afford for my family would be taken from me because the INCREASE IN MY FAMILY’S TAXES TO PAY FOR THIS SHAM WOULD RENDER ME FINANCIALLY UNABLE TO AFFORD “SUPPLEMENTAL” HEALTH INSURANCE FOR PRIVATE HEALTH CARE. I would lose GOOD health care and get crappy, government health care no matter what.
You attitude puts no value on a person’s will to take care of him or herself, and all the value on the nanny state providing for the folks unwilling to do so AT MINE AND MY FAMILY’S EXPENSE.
Your example is a lie and a sham. It holds no water. Try again, sir.
Posted by on 04/16/2008 at 02:03 PMI was about to reply to Mr. Hudson’s comment and see that Goober has said it for me.
As a resident of socialist New Zealand, Goober’s final line is spot-on, believe me.Posted by Keith on 04/16/2008 at 03:52 PMHi again,
I would very much like to open this debate up to the International Carnival of Pozitivities and would like to run a link to this post in the May edition. I need your permission, Mr. Porretto, to do so. Please let me know if you would agree. I think it might be interesting to hear from a wider audience of people who actually live in some of the countries whose health care plans differ from the US and from US citizens who have catastrophic illness.
The point made about undocumented non-citizens who live in this country is, indeed, an interesting one to consider. However, immigration reform issues, I think, are another issue from providing health care for US citizens. I hope that these 2 issues will be worked out as separate problems that overlap.
Regulatory issues are a part of the current system, that is true. The Medicare system is actually administered by the same insurance companies that are known to deny coverage to those who have preexisting conditions. That is another hole in the safety need that all Americans should have. Would you want all of the assets you work so hard to leave to your kids going to a medical facility or insurance company because you have had a debilitating stroke and require long-term around-the-clock care? It happens all of the time. Many Americans are just a disease away from ruin, even some who have been more fortunate than others. I would agree that we need to cut the paperwork and the discrimination out of the system. Corporate profit margins should not mean that people die because of red tape. And yes, people die all the time of many reasons, but should poverty or previous illnesses be a reason for them not to get the care that they need?
Goober, I applaud you for taking care of your family. Not everyone is able. How do we care for those who need help? It seems to me that the current system is universally unpopular with this audience. Medicare needs to be reformed, including the infamous doughnut hole in Part D. So does the insurance industry. I am simply saying that we have a need in this country for better health care and we are not making any progress toward it because of fear of change or fear that providing for one will deprive another. If you had an opportunity to provide input about what you want and need, wouldn’t you like to do so?
We need to get away from the assumption that those who can’t care for themselves are guilty of sloth. Are you aware that more than 4 people died in SC due to lack of access to AIDS medications just in the past year? Why should that happen in this country when we have more wealth and more resources than many other countries who do a better job of providing services?
I am enjoying learning your perspectives on this issue. It is enlightening to me to learn what concerns you. I don’t expect to convince you, but I hope that you will continue to engage me in discussion. Maybe we can at least understand each other better if not agree.
Posted by Ron Hudson on 04/16/2008 at 04:45 PMYou have my permission for nothing, Hudson. All the material submitted to this site is the copyrighted property of Eternity Road, and you are not authorized to use any of it—including your own comments.
You insulted me, you insulted my wife, and you insulted my country—you carry yourself as the purveyor of superior moral wisdom, as if God Himself had bestowed a revelation on you the rest of us haven’t received and are too dull to comprehend—and you want my permission to use the material at this site for your own purposes? I’ve seldom encountered that much brass. Well, everyone is exceptional in some way, though I’d surely have chosen some other distinction if I were you.
I’m already at work on an essay that will thoroughly renovate your anal anatomy, and I must say, I have seldom enjoyed the act of writing as I do at this time. Now go peddle your nonsense and your contempt on your own too precious site. You’ve already wasted enough of my server space.
Posted by Francis W. Porretto on 04/16/2008 at 05:25 PMMr. Hudson,
I see that Goober and Jeff Medcalf have defended much of my statement better than I might have. That being said, some things still need addressing.
“I see caring for us all as a nation as an issue of ethics and doing what is right.”
That’s all fine and dandy. But please tell why that means that I must see it as an ethical issue and then have my freedom to choose(and whether or not I pay money)removed by force. I want to choose. I don’t want politicians (who will use and abuse such a system) or even you Mr. Hudson(however benevolent your intentions) making such critical decisions for me.
“Just because the perception is there that we have a government system in disrepair (and I would tend to agree with you after the last 8 years), that does not mean that we as a nation can not persevere and improve. If France, Italy and even Andorra can do it, why can’t we? “
First of all, unless we are talking about regulations (as Jeff Medcalf said earlier), I don’t see it as a government system nor as a system the government should have any largescale involvement in. Only one it has meddled in way too much. And, as far as France, Italy and Andorra are concerned, those countries aren’t founded on the same principles as ours, namely the U.S. Constitution and its Amendments. What they do is their business, not mine.
“We have no safety net for life-threatening illnesses in this country. Some people can not work and have no support system such as family to fall back upon. “Go to work, get a better job” is just not a universally humane response.”
Actually, we do. Not one big government net, but a lot of little ones. They’re called charities. My wife and I donate to a couple that are very important to us. Millions of Americans do. If you can’t find a specific one, start one. Americans are some of the most generous people in the world. The problem is, so many of us want the say in who receives our charity. Is that so hard to understand?
In the end, ‘Universal Health Care’ is just another tool of control one that will demand yet more draconian measures to implement. It removes control from me, and yes, you. It gives it to our politicians who will then abuse it as they are want to do. To bestow more care on some, to withhold it from others. Do you trust them? I don’t. I can’t afford to.
I went to your blog (International Carnival of Pozitivities). HIV/AIDS is obviously a some of primary importance to you. Maybe you suffer from one. Maybe a loved one does. Maybe both. I don’t know and it really doesn’t matter as pertains to this.
But I have a question for you:
Would you want to have a politician(or bureaucrat taking his cue from a politician) deciding whether you get care or not? What if the Congress or the Executive Branch were controlled by a majority that viewed HIV/AIDS as a moral issue, not a health issue? What if they felt they could punish or regulate immoral behavior by denying those afflicted with a disease they consider an immoral one?
Would you willingly hand control of your life to an entity as fickle as our government?
Posted by Jim Sullivan on 04/16/2008 at 05:30 PMMr. Sullivan said:
“Would you willingly hand control of your life to an entity as fickle as our government? “And the entire cast of characters in my head broke into spontaneous applause!
Why would these people, the same people that think that the government fatally botched the Katrina effort, lied to get us into the Iraq war and then botched that, and a whole long list of other incompetencies, WANT to willingly give up the control of their health to that same government?
Government is not the answer, here, folks. Look at britain, where people judged overweight or obese by the BMI are being denied health treatments for totally unrelated maladies until they lose weight. Tom Cruise, Arnold Schwartzenegger, Shaq, and most of the members of any rugby, football, soccer, or any other sports team would be denied healthcare because all of the above listed people would fall under the rating of “obese” by the BMI. I am obese according tot he BMI. If you could see me, you would laught your ass off at how ludicrous that is. I can bench press almost 400 pounds. But I would be denied healthcare under the current, benevolent British system, becaue obesity has become the moral no-no du jour.
Posted by on 04/16/2008 at 07:27 PMMr. Hudson said:
“Goober, I applaud you for taking care of your family. Not everyone is able.”Why not? Illness? I have two rupured discs in my back and genetic immuno-deficiency disease that causes me to get VERY sick and break out in a psoriasis-like rash from my immune system attacking my skin over 90% of my body. It is hell on earth. I still go to work every day, missing only those days when I am physically ill to the point of being contagious, for the sake of my co-workers.
There are very few excuses that i will accept for being uninsured when you need to be. I did it for my family while going to college, pulling 23 credits per semester, and working 40 hours a week at the same time at a local lumber yard (who did not have health insurance). I simply found a way to get reduced cost insurance through a company that had such a program for students, and bought it with my own money.
I was not so focused on buying a plasma TV and having an 800 dollar air spoiler on my car that i neglected my familys health.
And for those that “cannot” (I like to say will not, but that is just me) do so fo their family should have considered that before having a family to begin with! Back in the old days, men actually had a sense of pride. Common was the case where a man would not marry his love until he found a way to properly support her, and more common was the man who worked as many jobs as necessary to support his family’s needs to ensure that they did not want. Like, for instance, the movie “Man from Snowy River.” People in today’s society do not understand why he left her in the end with prmise to come back. I understood completely. He needed to go make something of himself first. he needed to make a living, build a home, have enough to support her and their nascent family, before he took her away from her father’s home. Why is this so hard for the people of today to understand?
Why is it MY responsibility to pay for the punk who sweeps his love off of her feet, and then plunks her down in the middle of a bark hut with no shoes and not a penny to their name, when he starts whining about “not getting his?”
WHY?
Posted by on 04/16/2008 at 07:39 PMOh, and don’t give me that “too proud to go to charities” bullspit. That is nonsense. Too proud to go to a charity that is full of money that people WILLINGLY gave to your cause, but apparently OK with taking government handouts that were FORCIBLY IMPOSED upon people who may need the money for their own family. What a load of malarkey. Your role on this earth is to defend your family, and take care of them the best you know how. Failing to find a way to get them health insurance was YOUR failure, and it is now YOUR responsibility to go on bended knee, swallow your pride, and ask for help for THIER sake, not for your stupid pride. TO salvage one’s pride by governmental mandate, because you are too proud to go ask a charity for help, is just base.
Posted by on 04/16/2008 at 08:01 PMHere’s my situation: I’m a 29-year-old in good health except I suffer from seizures, pretty well controlled with medicine. Working for a company, I can get insurance under a group policy no problem.
But what if I wanted to go into business for myself? My condition blacklists me from getting insurance (I’ve tried). I’d have to do some extra risk analysis regarding going insurance-less.
Surely I am not the only one with this sort of disincentive to initiate such a vital economic activity. Is this good for the country?
This leads to another distinct disadvantage of private health care: the companies are in business to make money. Of course, you can’t blame a company for trying to make money. But it does mean that private health care has incentive to look for loop holes and grey areas to cover fewer conditions and pay less for a particular service.
No, I’m not really keen on politicians deciding what’s right for me. But neither am I ecstatic about putting the decision into the hands of a company that wants to spend the least amount of money on me as possible. It would be nice to have the option. Not everyone’s in the same boat.
Posted by Liquid Egg Product on 04/16/2008 at 08:18 PMLiquid Egg Product:
Insurance is just that: it is a way of guarding against unexpected conditions. If you were willing to put a rider on your insurance to not cover problems related to your (expected) seizures, I’m sure you would have no problem getting said insurance. (My family has such a rider for my wife’s GERD, and I am paying for my own insurance because I am an independent contractor. We put aside money to pay for the doctor visits and medicines related to the GERD.)
For some reason, we have decided that all health problems, including routine checkups, are somehow “unexpected,” and thus require our insurance to cover these expenses. Since the chance of those expenses being incurred approaches 100%, the insurance will add on its profit to the chance of being paid out, and lo and behold it now costs you more than it would to just go pay for the care. Where the chance is much lower (say, the chance of me having a seizure), insurance makes sense.
Posted by Jeff Medcalf on 04/17/2008 at 09:09 AMLiquid Egg Product:
I still have not seen the part where you show me why it becomes my responsibility to pay for your care. I stated earlier that I also have a serious, pre-existing condition, which would effect my ability to be insured for that condition, if i were not in a group program.
YOu state that your existing condition somehow gives you the right to go to the govrnment and request that they force ME to pay for your care so that you can live your dream of owning a small business.
So explain to me why you feel that way, please. I am sorry that you have a health condition. A lot of us do. But that does not give you or me or anybody cause to say that everyone else pay for me. Life isn’t exactly fair, man. If your health condition keeps you from starting your small business, that is just the pits. But why is that MY problem?
Again, all I can see here is pleas to sympathy, but no real, good reason why I should pony up for everyone else. We all have our crosses to bear. Mine is a genetic immune disease that will probably guarantee that i will have to be in a group insurance program for the remainder of my life, or, alternatively, pay the bill out of pocket.
Why do you feel that you are somehow special and require handouts so you can gt what you want?
Posted by on 04/17/2008 at 01:50 PMCanada’s health system is particularly noxious in that it is forbidden by law to acquire independent, private insurance for the purposes of health care. It’s the government-run system and no other! Just like North Korea and Cuba, incidentally. Naturally, people who are sufficiently wealthy simply take a flight to the US and get their procedure done there.
Posted by on 04/17/2008 at 03:21 PMJeff: The rider option is interesting; I was unaware of this, although no company mentioned the possibility.
Goober: Keep in mind I am able and willing to pay (and pay well above average due to my increased risk). I don’t want a freebie, just a chance to be able to contribute.
Even with private care, chances are you are paying for someone else’s care (esp if you never have to make a claim) Whether the money goes to a company or the gov’t, it’s still money spent.
The point of the small business was to demonstrate that this may affect other people. You or me starting a business necessitates having employees, generating a job someone else may need.
Posted by Liquid Egg Product on 04/17/2008 at 08:35 PM"Even with private care, chances are you are paying for someone else’s care (esp if you never have to make a claim)”
Irrelevant. Private care is voluntary, not mandatory. The reason it exists is specifically because insurance companies “pool risk” by taking money from healthy people to pay for sick people. That is how the industry works. But the important thing is that it is VOLUNTARY, and the everyone in it PAYS THEIR WAY instead of getting freebies off of other folk’s labor (lots of folks pay no taxes whatsoever. I pay plenty. I don’t WANT to pay more).
“Whether the money goes to a company or the gov’t, it’s still money spent”
A company is motivated to efficiency by profit, meaning their costs are minimized while the benefits are maximized. A company does not get a “holier than thou” attitude about social morals. If it is in the contract, they pay for it.
Government, on the other hand, is a MONUMENT to waste and inefficiency, meaning that all other things being equal, you’ll pay MORE for government healthcare than you will for private healthcare* in order to support the parasitic bereaucracy that will inevitably tie itself onto the healthcare system. They also bend to the moralities of the time, hence my statement about BMI earlier, and the other statement about HIV/AIDS. There would be no “contract” with the government. They could give and take care as they saw fit.
*The “all things being equal line about expense needs to be clarified. For some, healthcare will be FAR cheaper, for others, it will be free. But for those of us classified as “the rich” which is set at a ludicrously low level when you talk with a liberal, healthcare will be MONUMENTALLY more expensive, because of the parasitic nature of government bereaucracy, and also because we are footing 100% of the bill for everyone at a lower income level than us. How the middle class got included in “the rich” I’ll never know.
Posted by on 04/18/2008 at 06:12 PM"Should health care really be “universal?” “
No.
Kill the weaklings, improve the race.
OK, OK, don’t kill them. Let them die.
Wot, you disagree? I thought Liberals believed in evolution?
Posted by on 04/18/2008 at 10:57 PMGoober: Points taken. I agree that, in principle, paying for health care should not be mandatory.
On the other hand, our current system does have consequences. There are Americans unable to obtain or afford health care. What happens when they are faced with crushing medical bills, or have to decide whether to handle such bills?
Maybe a family with borderline finances will be forced to go with food stamps or reduced-cost school meals. Or someone who can’t afford optimal care will be on disability/unemployment longer.
These are also government-sponsored programs we pay for. How much less would we be paying with reduced use?
I don’t have the numbers. Without more information, it’s hard to determine who is objectively right.
There are also multiple ways to set up some sort of government-sponsored care. (Force-in or opt-in? How do doctors participate?) This is more complex than simply big gov’t = bad.
Final thing: private health-care reducing costs is not always good. This means they are motivated to spend as little on us as possible. People are sometimes denied procedures that a doctor would normally say is necessary.
Posted by Liquid Egg Product on 04/19/2008 at 12:03 PMShoot, forgot one thing. Those people which have money tied up in medical debt don’t have as much money free for other things, and tend to hunker down and spend less. If they had more money to spend this should contribute to growing the economy.
Is the growth in the economy worth paying a health care tax? Although the tax would reduce spending unless the tax approximates what we spend on insurance now.
And with any change, there will be winners and losers.
I have no clue how to evaluate this correctly. Chess is so much easier (and I can’t always evaluate that properly...)
(And thanks, Curmudgeon, for tolerating my not-orthodox-for-this-site rants.)
Posted by Liquid Egg Product on 04/19/2008 at 12:17 PMI’ve tolerated them, Egg, for a single reason: I want to see how smart you are. Here’s the final exam:
Argue against your own position.
You’ve made certain assumptions, possibly without realizing it, that cannot be objectively justified. You’ve overlooked certain conditions which gave rise to the problem of expensive health care, possibly because they pre-date your acquaintance with the subject. Acknowledgement of these things would cast your argument into great uncertainty. They wouldn’t remove it entirely from relevance, but they’d compel you to take a much wider approach to the health-care “problem” than you have to date...than most people ever do.
This is an open-book test. Get cracking!
Posted by Francis W. Porretto on 04/19/2008 at 12:28 PMLOL! Do I get a day or two?
Posted by Liquid Egg Product on 04/19/2008 at 06:33 PMHey folks, per request, input fro outside the USA.
Background first; born in Iowa; grew up around Chicago, 20 years in New England, was one of the lucky few to have a carry permit in Massachussets not because of connections or money.
And I spent 20 years working in the Insurance industry, much of that self insured as I was an independent contractor (S Corp 1099) and it was cheaper. This with a wife with MS and a bunch of kids who got to see the dentist on a regular basis.
I have a pretty good idea, I think at least, how things work, and I am a self described conservative.
I made aliyah to Israel 4 years ago, and have had a fair amount of exposure to the Isaeli system. It works. It’s an odd blend of socio-capitalism that I have not seen anywhere else.
First of all, Health coverage is universal and mandated by law. You must sign up with one of the four Health Funds, which function much like an HMO was supposed to. You pay a tax every month on a sliding scale, based on Income. For every member of te Health Fund, the Govt kicks in additional funds out of general revenue taxes.
What the Health Funds cover (notice no one calls them Insurance) is mandated by law, and basicly except for stuff like fertility treatments and elective plastic surgery, if you have a problem your will be taken care of.
Prescriptions cost about $5 or so, in most cases, and the elist of what drugs are covered is extensive. You will get generics by default (Israel is a big time manufacturer of these) and some of the exotic cancer drugs (the $10,000 a month type stuff) may not be covered. There is an annual review of the list and you can get some serious PR pressure going when some family has a sick kid that needs something not on the list, but it all works out in the end.
You can pay in extra into the Health Fund for extra coverage (e.g. Dental).
You can pick your doctor and getting referred to a specialist is no problem.
There are no long waiting times in general, but there is a rationalization of resources. For example, not every clinic has an Ultrasound machine, you may need to travel 30 minutes to the next big town for that.
Or, for example, in the town I live nearby there is one private X-Ray lab. It serves the patients of all four Health Funds. If you get a referral from you doctor, you pay nothing.
So it turns into three trips, visit the family doctor, take the referral to the Xray lab, return to the Doctor with the Xrays for evaluation.
But I can call up the 24 hour “make an appointment with a doctor phone line” and get to see the doctor of my choice within 24 hours.
What makes it work?
It’s open, with minimal government interference. The Knesset sets the goals, but how each HEalth Fund gets there is up to them.
It’s competetive. Each Health Fund tries to attract more patients and deliver care in an efficient manner.
Doctors don’t get rich, and they come to work in blue jeans like ever one else.
Lawyers don’t get rich, the threshold for a malpractice claim is high enough to stop the trivial bullshit, there is no ‘Malpractice Insurance’ and the Health Funds are liable, not the Doctors, so they police themselves pretty well.
The point is, that whether is would work for the USA, there is a system in place that does demonstrably work.
However it does so by keeping, for the most part, the government out of the loop.
Open for conversation!
John
Posted by on 04/22/2008 at 01:22 AM
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