Universal Healthcare Inevitable?

[quote]BackForMore wrote:
lixy wrote:
BackForMore wrote:
LIFTICVSMAXIMVS wrote:
BackForMore wrote:
In say the last hundred years precisely which wars to you believe were started by the United States?

Technicalities. Declaring war is starting war. Since we haven’t declared a war since WWII, technically, we haven’t started a war.

We just partake in humanitarian intervention.

I was getting at the fact that the USA isn’t in the habit of starting wars but we tend to be in the habit of cleaning up those started by others, principally Europeans.

is that sarcasm?

Please. If the USA had a corporate mission statement it would be something along the lines of, “America: Taking out the Eurotrash since 1776”. And for the record no, that was not sarcasm.
[/quote]

And the Caribean trash and the Middle Eastern trash and the South East Asian trash, whether there was trash there before or not, whether it was dumped there by Americans or with the help of Americans or not…

Please, just keep your own house clean, I really do think Americans do deserve a solid infrastructure, a fair justice system and a political system where votes are actually translated into political change.

If there is one thing to be proud of in the European Union it is that we inspired whole nations to become free market democracies with solid justice systems just by being an example.

They changed to join us, as Turky does right now and has been doing for decades.

We are the shining city on the hill.

[quote]orion wrote:
I think that all of you are missing a point, they need the money and they get it where they are legally allowed to.

Someone has to pay for the services they provide at gunpoint and in that case it is you.

It is easy to blame the hospitals, but they are only reacting to a situation they were forced into.
[/quote]

Yes, the government mandate that hospitals always provide emergency care to everyone is the root of the issue. So the government should foot the extra costs caused by that mandate, not the consumer with no insurance.

[quote]ElbowStrike wrote:

I think the problem here is that thanks to decades of anti-communist propaganda, Americans have an irrational fear of anything associated with collectivism and socialism, no matter how effective.

They see “individual” and “collective” as black and white instead of a spectrum of responsibility. An ideal society would fall somewhere about halfway between responsibility and respect for the collective and for the individual.

A “society” where the individual is the only priority is the absence of society.

ElbowStrike[/quote]

The collective? Kind of reminiscent of the Borg.

But you are correct, it is best to look at socialism and capitalism as a continuum instead of black and white.

That being said it should be pointed out that socialism simply does not work. This is not propaganda, but a cold hard fact. Simply look at every time it is implemented, and it always runs into problems.

But it is very enticing. It sounds so good. Everyone working together for the common good. Brothers and sisters all sharing, and benefiting society. No more poverty, no more hunger. Are we not supposed to care about people?

Yup, if you don’t believe in socialism, you are an evil person. You only care about yourself.

Problem is its all wrong. People are so intent on helping their fellow man, they haven’t taken the time to figure out if they are really helping or not.

China took it the furthest and actually implemented equal pay for everyone, no matter what. A full third of the population immediately quit their jobs.

Before you give somebody something, make sure you are actually helping them, and not simply creating co-dependence. The research into the book the millionaire next door found that the more financial help people received from their parents, the less likely they were to be financially successful. And the opposite was true too.

One big mistake being made is the idea that you are doing good if it makes you feel good. Sometimes doing the right thing, and helping people the most can hurt, and it can hurt bad.

Next time you go into the gym, pay somebody else to lift the weights for you. Will you get stronger? Hell no. But right now millions of people want the government to lift their weights for them.

Socialism is not a solution, it is the easy way out.

But capitalism does in fact work, and as I have stated over and over, it is because it mimics nature. Survival of the fittest. (For some reason I have been called a racist for stating this when this has nothing to do with race.) Many people start businesses, and many fail. (Though not barely as many as is too often stated.)

Run your business well, and competitively, and you can become successful. But if you are lazy, greedy, dishonest, it is actually harder to become successful. Yes I know you heard all businessmen are crooks, and always hear news reports about businesses taking advantage of people, because they always get caught, or screw up in some way.

But the news does not report on businesses that are honest, because that is not news.

Do you think oil is so high priced because it is so scarce? No, it is the government getting in the way, blocking drilling, exploration, and the building of refineries. (Plus creating a different fucking blend for every city in America.) Why does it cost as much as $1,000,0000,000 (billion) to bring a drug to market? Because the FDA really cares about us? (At least they saved us from MAG-10.)

Socialism is about somebody making choices for you. Somebody thinking for you instead of you thinking for yourself.

Now why do you think some bureaucrat in Washington can decide how your supposed to live your life better then you do?

Must I join the collective? Is resistance futile?

[quote]orion wrote:
kroby wrote:
No one should make a greedy buck off the misery of any person.

I agree.

Let us nationalize farms because they exploit that people are hungry.

The textile industry because people get cold, all doctors because they benefit from peoples misery, undertakers, for obvious reasons.

So profiting from others needs is ok, unless someone really, really needs it?

And then you are greedy for providing it cheaper and better than the person itself could`?

[/quote]

I was thinking those very things when writing my shpeel. I wanted to distinguish between “normal” transactions and those of hucksters, confidence men and other unsavory types that would rob their mother if given the chance. I failed at that, and thank you for the opportunity to clarify.

[quote]orion wrote:
BackForMore wrote:
katzenjammer wrote:
Rights are not created by the state Lixy.

In most European conceptions of the relationship between government and the citizenry they are. The state giveth and the state is free to taketh away, hence the bloody wars that rage across the continent from time-to-time … but that’s another discussion entirely.

Hence the bloody wars the US starts regularily?

[/quote]

Someone’s gotta be the cop once in a while and lay a billy club across some asshole’s head. Of course, when the Euro takes over, you guys get to do this thankless police job. Can we then sit back and call YOU evil and ‘starter of bloody wars’?

[quote]Headhunter wrote:
orion wrote:
BackForMore wrote:
katzenjammer wrote:
Rights are not created by the state Lixy.

In most European conceptions of the relationship between government and the citizenry they are. The state giveth and the state is free to taketh away, hence the bloody wars that rage across the continent from time-to-time … but that’s another discussion entirely.

Hence the bloody wars the US starts regularily?

Someone’s gotta be the cop once in a while and lay a billy club across some asshole’s head. Of course, when the Euro takes over, you guys get to do this thankless police job. Can we then sit back and call YOU evil and ‘starter of bloody wars’?

[/quote]

If we become stupid enough to go down that route, yes.

[quote]BostonBarrister wrote:
orion wrote:
I think that all of you are missing a point, they need the money and they get it where they are legally allowed to.

Someone has to pay for the services they provide at gunpoint and in that case it is you.

It is easy to blame the hospitals, but they are only reacting to a situation they were forced into.

Yes, the government mandate that hospitals always provide emergency care to everyone is the root of the issue. So the government should foot the extra costs caused by that mandate, not the consumer with no insurance.[/quote]

Orion is somewhat mistaken. Here are some realities:
–The mandate to take care of the uninsured in ERs is clear.
–When managed care (HMOs) fails, primary doctors do not want to see complicated or sick or litiginous patients. Why work harder for less? The patient will be told to go to the ER. In many states, the hospital ER must take the discounted rate for services given to ER pts, even if the HMO refuses to pay for “non-emergency” care.

–Last, hospital prices are a complete fiction, and no sane uninsured person pays the nominal prices; they are negotiated down, and somewhat randomly. Even foreign patients will ask to pay Medicare or Medicaid rates, and get them or better.

No hospital is making up revenue by taking money from the uninsured; there simply is no volume of revenue to match the costs.

Now, here is something else to think about, and I have no published references for it.
It is rumored that my "not-for-profit’ hospital generates more “profit” from its Charitable Foundation (and much higher return on capital) than it does from all its medical care.

In short, a hospital in this situation sees its “medical care” operation as a loss-leader, and relies on charitable donations and untaxed investment income as its chief business. If this is true, the hospital is in the investment business, and medical care is just the way it attracts charitable donations.
How screwed up is that?

[quote]thunderbolt23 wrote:
ElbowStrike wrote:

Except that public health care in Britain, Canada, and many other countries costs significantly less per patient for equal or better care.

Bolded portion incorrect.

And, part of the costs savings - whatever their measure - are in large part due to the research dividend provided by the larger private medicine sector of the US.
…l.[/quote]

First, a definition of terms to explain myself. Health care is a public good measured in a population. Medical care is what happens to an individual. The goals are different–population benefits versus individual benefit–and measured differently.

Now for ElbowStrike’s contention. Who measures, and how?
Individuals, or groups of sick patients, may have terrible care unreflected in measures of the common measures of health care–mortality, costs, etc.

Example 1. My friend’s sister-in-law was 42 has lupus and had brain dysfunction. However features of her condition were compatible with multiple sclerosis. She lives in St. John, Newfoundland, and was told she had to wait 6 months for an MRI, or be put on a waiting list and maybe she would be scanned in 6 weeks.
In the meantime, she would be untreated, and have loss of brain function, like multiple strokes. Or would she get chemotherapy, which might help lupus quickly, but has toxicity? Or should she get both chemotherapy and toxic therapy for acute MS, and hope that when the scans were done, it would all turn out ok, and after all…what difference would it make?
Her event will not show up in the public health care figures that ElbowStrike considers. In her case, it was certainly cheaper.

Example 2. I was unable to find the citation for this one. Just a few years ago, Britain reported its results on breast cancer survivorship. The 5 year survivorship was 20% less for older women than the comparable figure for the US and Italy. This was directly attributed, not to public health measures, but to the practice of the National Health to withhold adjuvant chemotherapy from older women. Cheaper care, and the British populace knows no better.

The US will not work this way. We are too demanding, too impatient and too litiginous to allow this, and we are too cheap to pay for better that what we have now.

[quote]The Mage wrote:
ElbowStrike wrote:

Must I join the collective? Is resistance futile?[/quote]

Well, you pay income tax - a collectivist practice. That must make you a communist.

Yes, absolute capitalism works better than absolute collectivism.

Both systems fail to provide the best outcome for society because of game theory.

In an absolute Libertarian “paradise” where nobody has to pay taxes and all government spending is voluntary, it’s in nobody’s personal best interest to donate to government projects.

If my business competitor is going to donate ten thousand dollars to the new subway system, I’m going to spend ten thousand dollars on my own business to make it more competitive.

Knowing that I will do this if he donates, my competitor will not donate in the first place and instead invest in his own business.

Since a not-for-profit subway run by the city can’t be built, a for-profit subway is built.

Since it doesn’t make economic sense to dig parallel tunnels with the now-in-business subway system, no competitors surface and the subway company operates a monopoly, coming a price setter and jacking consumers, rather than charging true market value.

In an absolute Communist “paradise” where everyone is paid the same and everyone works to their ability, like you pointed out one-third of people quit their jobs. People just go to work so they have “something to do” and quit when they don’t feel like working anymore.

The diseased, elderly, and disabled are all cared for but nothing gets done and the economy remains stagnant.

After all, why go to work if you’re going to get paid the same for sitting at home while someone else works their ass off? You’re at a personal advantage compared to others if you don’t go to work.

Game theory ruins both capitalism and communism, which is why the mixed economy is in practice everywhere in the world. It’s the better way, we’re all just in the process of finding the optimal balance between individual and collective policies.

ElbowStrike

[quote]ElbowStrike wrote:
Both systems fail to provide the best outcome for society because of game theory.
[/quote]

What is the best outcome?

Game theory doesn’t apply to economics. It is not strategic interaction but rather mutually beneficial action.

For any voluntary exchange to happen both parties must believe they would be better off than they would be by not making an exchange; otherwise there would be no transaction. It is not a game.

[quote]DrSkeptix wrote:

–Last, hospital prices are a complete fiction, and no sane uninsured person pays the nominal prices; they are negotiated down, and somewhat randomly. Even foreign patients will ask to pay Medicare or Medicaid rates, and get them or better.[/quote]

I think this is problematic - particularly for those uninformed about this. When I was young and stupid, right out of undergrad, I cut my thumb and got some stitches - I think there were 4, and it took 20 minutes (once I actually got in to see the doctor). Of course, I hadn’t started working yet, and so was uninsured (Murphy’s Law - the only time I was uninsured from birth through now was one of the only times I ever went to the hospital). I got the bill - $500 or so from the hospital, and a separate bill for $400 or so from the doctor. Naive lad that I was, I paid it on my credit card - then paid off the credit card over the next several months.

Ridiculous.

Just an anecdote of course, but there I was, in my 20s, college educated and assuming I had to pay the bill because I had signed something saying I would pay the bill.

[quote]DrSkeptix wrote:
No hospital is making up revenue by taking money from the uninsured; there simply is no volume of revenue to match the costs.[/quote]

Unfortunately, that doesn’t stop them from trying - and ruining people’s lives: http://www.doublestandards.org/borger2.html ; or just Google “hospital collection bankruptcy” and see how many attorney adds come up - there’s obviously enough of a practice to sustain these folks. Here’s an organization: http://www.hospitaldebtjustice.org/about.html

It’s actually even becoming a problem for people with capped insurance, given the size of the bills and the fact they often run up tabs without knowing they are over the cap: As Medical Costs Soar, The Insured Face Huge Tab - WSJ

But that’s a separate issue of the insurance company passing the buck to patients for cost control - and the patients generally aren’t aware.

[quote]DrSkeptix wrote:
Now, here is something else to think about, and I have no published references for it.
It is rumored that my "not-for-profit’ hospital generates more “profit” from its Charitable Foundation (and much higher return on capital) than it does from all its medical care.

In short, a hospital in this situation sees its “medical care” operation as a loss-leader, and relies on charitable donations and untaxed investment income as its chief business. If this is true, the hospital is in the investment business, and medical care is just the way it attracts charitable donations.
How screwed up is that?
[/quote]

Not exactly on your point, but here’s another data point on not-for-profit hospitals:

http://www.kaisernetwork.org/Daily_Reports/rep_index.cfm?DR_ID=51358

Some of the biggest spend less on charitable care then they receive in tax breaks. Seems kind of backwards.

Universal healthcare will not work in the US until people change their expectations. There is no possible way that the US can provide healthcare to the same level that someone can access it now. In other words, with universal healthcare there will be limits on access and coverage that do not currently exist.

Most people in the US have an entitlement attitude and expect money for nothing and chicks for free. That attitude must change for universal healthcare to be successful.

THANK YOU, Lorisco!

As Americans we ARE too entrenched in not only our feelings of entitlement; but I want it NOW!

NO candidate (that I’m aware of) have spoken about how Americans themselves must be “reformed” before there is any any way that “Universal Care” will work.

Litigation reform is a must.

And something else not discussed by the Politicians; the inevitable creation of a two-tied Health System for the “haves-and-have-nots”; with obvious differences in both quality and access.

Its the American Entrepreneurial way; the rich will demand a certain level of care, and someone will step in to provide it.

Don’t think for one instant that an Oil Executive and his family will be receiving care beside illegal immigrants.

Fire away!

Mufasa

Canada’s a great place to live, just don’t get sick.

[quote]Mufasa wrote:
Don’t think for one instant that an Oil Executive and his family will be receiving care beside illegal immigrants.
[/quote]

This is the case everywhere. Rich people will always have other options though they may not have the option to pay for it or not. I guarantee you rich people in Canada will find the care that best suits their means and ends.

I don’t regard the market as an entitlement system. We have to pay for everything we want or need. Why shouldn’t a person with access to greater means be “entitled” to greater ends?

[quote]LIFTICVSMAXIMVS wrote:
Mufasa wrote:
Don’t think for one instant that an Oil Executive and his family will be receiving care beside illegal immigrants.

This is the case everywhere. Rich people will always have other options though they may not have the option to pay for it or not. I guarantee you rich people in Canada will find the care that best suits their means and ends.

I don’t regard the market as an entitlement system. We have to pay for everything we want or need. Why shouldn’t a person with access to greater means be “entitled” to greater ends?[/quote]

I never said they shouldn’t.

However, the Politicians are painting Universal Healthcare like it’s some “Xanadu”, much like the Marxist painted Communism (and NO…I am NOT painting Universal Healthcare with a “Communist Brush”; merely its presentation to the American People).

What they paint is the idea that there will be Universal Care with the same quality and access…and that simply will NOT be the case.

And believe me, the rich are NOT the only ones with an “entitlement” mindset. Some of the most demanding people I’ve ever met probably haven’t worked a day in their lives.

As Lorisco said, Americans just don’t have the right mindset for a Universal System; and they better be prepared for poorer quality of care; much more limited access; and less ability to sue.

Right…

Mufasa

[quote]Mufasa wrote:

NO candidate (that I’m aware of) have spoken about how Americans themselves must be “reformed” before there is any any way that “Universal Care” will work.
[/quote]

Very early in Barack Obama’s Campaign he made a speech where the central message was (paraphrased) “I cannot fix the things that are broken with this country, I cannot change the way things work, and I cannot make your lives better. Only WE can do that, together. It is not my responsibility, it is our responsibility. Every one of you needs to want it, and work for it in your own lives. You cannot count on the Government, myself, or anyone to give it to you.”

Since he became the frontrunner and more or less runaway success, he has not talked about this very much at all. Where has since hyped up the hope and change and idealism whilst toning down the need for individuals to ‘reform’ themselves.

But the sentiment was there earlier in the campaign. Personal Responsibility and accountability amongst individuals being the only way to actually improve the quality of living in this country. That is a message that is not Republican or Democratic, and I think it is something that everyone could stand to listen to and take example from.

Unfortunately, people don’t want to hear that stuff, even if it is true. They like the idea of it, until someone tells it to their face.

Great stuff, Malevolence!

Mufasa

[quote]Mufasa wrote:
LIFTICVSMAXIMVS wrote:
Mufasa wrote:
Don’t think for one instant that an Oil Executive and his family will be receiving care beside illegal immigrants.

This is the case everywhere. Rich people will always have other options though they may not have the option to pay for it or not. I guarantee you rich people in Canada will find the care that best suits their means and ends.

I don’t regard the market as an entitlement system. We have to pay for everything we want or need. Why shouldn’t a person with access to greater means be “entitled” to greater ends?

I never said they shouldn’t.

However, the Politicians are painting Universal Healthcare like it’s some “Xanadu”, much like the Marxist painted Communism (and NO…I am NOT painting Universal Healthcare with a “Communist Brush”; merely its presentation to the American People).

What they paint is the idea that there will be Universal Care with the same quality and access…and that simply will NOT be the case.

And believe me, the rich are NOT the only ones with an “entitlement” mindset. Some of the most demanding people I’ve ever met probably haven’t worked a day in their lives.

As Lorisco said, Americans just don’t have the right mindset for a Universal System; and they better be prepared for poorer quality of care; much more limited access; and less ability to sue.

Right…

Mufasa[/quote]

That is correct sir! The care that those receive now via health insurance is much better than it will be under a government run system. Once the free market is taken out of the equation the costs will be way too high to deliver cutting-edge care. So care will be rationed and the overall quality will be reduced as there will be no financial incentive for new innovation.

As far as the rich getting better care; that is the way it should be in a free market system. I have no problem with rich people being able to buy the best cars, the best wives, the best anything. Their spending and investment gives us jobs and income.