Is United States Universal Healthcare Feasible? [Archive I]

Nitrousoxide

May 20, 2007, 08:36 PM

Those on this board for whom socialised medicine is anathema will argue that it isn't possible, despite the evidence that every other Western nation has socialised medicine.

They will say that the US is subsidising medicine for the rest of the world, as if abandoning yourself to the mercy of big pharma and laissez-faire non-regulation and then paying the price should be blamed on other nations.

They will ignore the fact that nationalised healthcare does not necessarily come at the cost of private healthcare (even though private healthcare is less efficient).

Let's wait for the first appeal to Cuba.

(I also predict Michael Moore's Sicko will inspire some debate, though, like all projects of the kind, won't change anybody's mind).

So far, there isn't a good reason to think that socialized medicine will actually improve many of those important health indicators.

Lifespan is incomparable because of a differing definition of "live births" and "still births."

Indicators like heart disease rates are partly due to the quality of medicine, but also due to lifestyle choices. Many Europeans are quick to point out, Americans are fat, sloppy slobs compared to them.

So far, I've not seen any convincing evidence that socialized medicine will improve the health of the nation noticeably.

Loren Pechtel

May 20, 2007, 08:44 PM

Recently, I had read an assessment of Japan's healthcare as 10th in the world and the US's as 37th. I think that Japan's healthcare system offers an excellent rational model of full coverage. Japan's healthcare system is universal in that everyone is covered. There is also at the same time, a capitalist healthcare industry just like in the US. The full system is not that different so transitioning from the US system to the Japanese system should not be too difficult.

That 37th is bad data. I don't know where we should rank but that's not it.

coloradoatheist

May 20, 2007, 09:35 PM

I think it will happen in the future and we'll move to a two-tier system. All that will happen is that the people with "free" health care will get less treatment, longer lines, and be second class citizens to the people who purchase private insurance and costs won't be lowered wih our govt.

As far as the stats, a lot of our health insurance costs are measured while it's benefits aren't measured.

Mike

Metaphor

May 20, 2007, 09:59 PM

So far, there isn't a good reason to think that socialized medicine will actually improve many of those important health indicators.

Lifespan is incomparable because of a differing definition of "live births" and "still births."

Indicators like heart disease rates are partly due to the quality of medicine, but also due to lifestyle choices. Many Europeans are quick to point out, Americans are fat, sloppy slobs compared to them.

So far, I've not seen any convincing evidence that socialized medicine will improve the health of the nation noticeably.

Public health is only one of the arguments. Nationalised medicine means a more efficient system (I posted several links on the old PD board) and, at an individual level, it means health is not compromised by the fear of costs.

Malcolm Kirkpatrick

May 21, 2007, 12:06 AM

US taxpayers can afford universal coverage if all you want to offer is one band-aid per person per year. The entire US GDP is insufficient if you propose to keep even one person alive forever.

There is no reason to suppose that a State-monopoly health-care system will outperform a competitive market in medical services. Across industries, monopolies deliver wretched services at high costs and subsidized goods are over-consumed. State actors are no more competent to deliver medical services than they are competent to make shoes or operate restaurants. The government of a locality is the major dealer in interpersonal violence in that locality (definition), an extortion racket or, if you prefer, a giant security subdivision or giant shopping mall with it's own security force. These are the people who operate police forces, courts, prisons, and tax agencies. They have no special medical expertise.

Randall G. Holcombe
Government: Unnecessary but Inevitable (http://www.independent.org/pdf/tir/tir_08_3_holcombe.pdf)
The Independent Review, Volume 8 Number 3, Winter 2004

Eduardo Zambrano
Formal Models of Authority: Introduction and Political Economy Applications
Rationality and Society, May 1999; 11: 115 - 138.

"Aside from the important issue of how it is that a ruler may economize on communication, contracting and coercion costs, this leads to an interpretation of the state that cannot be contractarian in nature: citizens would not empower a ruler to solve collective action problems in any of the models discussed, for the ruler would always be redundant and costly. The results support a view of the state that is eminently predatory, (the ? MK.) case in which whether the collective actions problems are solved by the state or not depends on upon whether this is consistent with the objectives and opportunities of those with the (natural) monopoly of violence in society. This conclusion is also reached in a model of a predatory state by Moselle and Polak (1997). How the theory of economic policy changes in light of this interpretation is an important question left for further work. [Eduardo Zambrano, "Formal Models of Authority", Rationality and Society, V.11, #2. May, 1999].

gargoyle

May 21, 2007, 12:22 AM

So far, there isn't a good reason to think that socialized medicine will actually improve many of those important health indicators.

Lifespan is incomparable because of a differing definition of "live births" and "still births."

Indicators like heart disease rates are partly due to the quality of medicine, but also due to lifestyle choices. Many Europeans are quick to point out, Americans are fat, sloppy slobs compared to them.

So far, I've not seen any convincing evidence that socialized medicine will improve the health of the nation noticeably.

The go to the OECD (an organization for promoting market based reforms) and look at indicators for infant mortality, life expectancy and years lost to preventable disease. Socialized systems out perform the american system in every area at less than half the cost. The rankings of international systems is done by the OECD - they also audit systems for strengths and weaknesses, and advise nations on how to fix their medical, primary, secondary and post secondary education systems etc.

gargoyle

May 21, 2007, 12:23 AM

That 37th is bad data. I don't know where we should rank but that's not it.

What about #1 in profit... #37 in performance!

gargoyle

May 21, 2007, 12:28 AM

There is no reason to suppose that a State-monopoly health-care system will outperform a competitive market in medical services.

You are 100% correct there is no reason to suppose anything - there is only evidence... and the evidence overwhelmingly shows that socialized single payer systems deliver superior health care results at half the cost.

Say it with me:

"Socialized single payer systems have lower infant mortality, higher life expectancy and less years lost to preventable disease at half the cost of the american medical system while providing universal coverage to all their citizens."

Malcolm Kirkpatrick

May 21, 2007, 12:49 AM

(malcolm): "There is no reason to suppose that a State-monopoly health-care system will outperform a competitive market in medical services."
You are 100% correct there is no reason to suppose anything - there is only evidence... and the evidence overwhelmingly shows that socialized single payer systems deliver superior health care results at half the cost.Two problems with this evidence:
1) Wildly different populations (e.g., lots of immigrants in the US)...
2) The same agency (the State) which delivers the service collects the statistics.Say it with me:

"Socialized single payer systems have lower infant mortality, higher life expectancy and less years lost to preventable disease at half the cost of the american medical system while providing universal coverage to all their citizens."Say it with me: "Socialism is an infantile power fantasy."

Metaphor

May 21, 2007, 03:16 AM

Metaphor

May 21, 2007, 03:19 AM

(malcolm): "There is no reason to suppose that a State-monopoly health-care system will outperform a competitive market in medical services."
Two problems with this evidence:
1) Wildly different populations (e.g., lots of immigrants in the US)...
2) The same agency (the State) which delivers the service collects the statistics.Say it with me: "Socialism is an infantile power fantasy."

1) Australia has lots of immigrants, too. Is there a reason to suppose documented immigrants are in poorer health than natives? (If anything, given that they must pass medicals, they would be in better health).

2) You've now conflated socialism and socialised/universal healthcare. Australia is by no means socialist, but we do have universal healthcare.

Styrofoamdeity

May 21, 2007, 04:09 AM

Let's see- Chrysler is almost bankrupt and other US automakers now have no chance of competing with foreign makers. Mainly because they are weighted down with gigantic health care costs, while Japanese companies are lean and highly profitable for NOT having to pay health care. And conservatives in the US still manage to be "pro-business" and against government health care?? Fricking amazing.

The health service here in Japan is incredible. Keep in mind that Tokyo is by many estimates the most expensive city in the world. I will compare a dental emergency I had two months ago in Japan with my sister's recent dental emergency in America:

Me- I had a wisdom tooth pulled out, but there were complications due to the way it was imbedded, so surgery took one hour. Total cost: $20. Total cost of two types of medicines, including pain killers: $7. I had some pain after a few days so called the dentist back. They took me the same day. Total cost of treatment the second day: $9. New prescription: $1.10 (yes, that is one dollar and ten cents).

My sister- She is a diabetic on disability. Unfortunately like many diabetics she has lost her teeth, though she is relatively young. She lost her false teeth (flushed them down the toilet). She has made more than 20 telephone calls and visits to various government offices, but she still has no teeth after almost three months. I have sent her $1,000 to cover a new set, but no dentists are very interested in seeing a low-income person whose dental care requires a bunch of state paperwork. She's on some kind of "waiting list". Meanwhile she is too embarrassed to go outside since she has no teeth. She still has no definite answer about how much longer the paperwork is going to take. No one is interested.

I have no idea how much it would cost me to buy her new teeth without her state provided "medical care", but I am supposing it would be many thousands of dollars. In Japan, a diabetic would have had his or her new teeth within the week, and it is doubtful that the cost would have exceeded $50.

The US message to low income and middle class people who need emergency medical care: Please die.

Don2 (Don1 Revised)

May 21, 2007, 06:20 AM

The US message to low income and middle class people who need emergency medical care: Please die.
I don't get it, Styrofoamdeity, because it is like no one read the op. I am not proposing something radical. The Japanese system is not that different from the US system and I am not proposing the Cuban system. I expressed this in the op and it is in the links. Can you do me a favor and expand on the small differences that led to full coverage in Japan?

Gooch's dad

May 21, 2007, 07:01 AM

Bonniedundee

May 21, 2007, 07:26 AM

They will say that the US is subsidising medicine for the rest of the world, as if abandoning yourself to the mercy of big pharma and laissez-faire non-regulation and then paying the price should be blamed on other nations.What kind of large drug comapny(or any large company.) actually does or wants to operate by the complete laissez faire?
Just look at the amount of regulations and support given to drug and health companies.

They will ignore the fact that nationalised healthcare does not necessarily come at the cost of private healthcare (even though private healthcare is less efficient).
I'm not sure what you mean by "private healthcare", because even today, in America, almost all drug and health companies are ridden with statism, but how can it be less efficient, it would actually respnd to consumer demand rather than being financed by taxes.

Alter

May 21, 2007, 07:42 AM

Metaphor

May 21, 2007, 07:43 AM

What kind of large drug comapny(or any large company.) actually does or wants to operate by the complete laissez faire?
Just look at the amount of regulations and support given to drug and health companies.

What I'm referring to is the self-imposed handicap of government not negotiating with big pharma for lower drug prices.

I'm not sure what you mean by "private healthcare", because even today, in America, almost all drug and health companies are ridden with statism, but how can it be less efficient, it would actually respnd to consumer demand rather than being financed by taxes.

I'm not sure what you mean here - nationalised health care DOES respond to consumer demand - how could healthcare be otherwise? You come in with a toothache, you don't get treatment for cancer.

Private healthcare is less efficient than public healthcare in Australia - ie it costs less money (doctors, nurses, theatre time, etc) to process a patient in the public system than it does in the private system. The private system has the additional overhead of claims made for various procedures.

Roads are financed by taxes too - what's your point?

Metaphor

May 21, 2007, 07:46 AM

Here's the problem with nationalized healthcare, especially the Canada model where private health insurance is not legal:

Poor folks: Nationalized health care is much better than no health care.

Rich folks: Nationalized health care is the same as private health care. They're rich enough to pay for whatever care they want.

Middle-class folks: Nationalized health care is far worse than private health care. You have waiting periods for treatment, you cannot see your chosen specialist, if you want to pay a higher co-pay to go to a better doctor you can't, some things (like epidurals for women giving birth) are not available on weekends, and if you have any rare, expensive-to-treat disease you're completely out of luck.

I must disagree, but partly because I don't know where you are drawing the line between poor and middle class.

You are also assuming that nationalised health care precludes private health care? In Australia if you are middle class, you can pay for private health care and get quicker treatment if you want it.

Also, the bulk billing system for GPs in Australia benefits the middle classes too.

Yes, Canada gives better outcomes in aggregate. But for any specific middle-class person, the outcomes are likely to be worse or much worse.

Styrofoamdeity

May 21, 2007, 07:52 AM

I don't get it, Styrofoamdeity, because it is like no one read the op. I am not proposing something radical. The Japanese system is not that different from the US system and I am not proposing the Cuban system. I expressed this in the op and it is in the links. Can you do me a favor and expand on the small differences that led to full coverage in Japan?

The oddity about the Japanese system is that it is so fair and so standardized, that there is precisely no difference between the care you receive and that of another person. Rich, poor, self-employed, or employed at a mega-company, it's all the same when you are at the clinic or hospital. Each person must have a government medical card or a card issued though their company health plan, but at reception IT'S ALL THE SAME. No one is made to feel like shit just because their insurance is supplied 100% by the government rather than through a company plan.

The amazing thing is that there is virtually no paperwork. None of the piles of documents required in the USA. You present your medical card and the clinic does the rest.

We have endless numbers of small clinics, and doctors here are rich, just like they are in America. I've got friends who own a small clinic and they are multi-millionaires. So it is not a question of underpaid doctors as you have in some countries where doctors are paid by the state. Japanese doctors are professional and well-trained.

In my case, I am a very healthy person making a relatively high income, so there is no doubt that I am subsidizing the health care quite a few people. But that's fair enough as far as I am concerned, as I'll be old some day. My father in law in Japan, who is not wealthy, was hospitalized for bowel cancer last year for a period of 10 weeks. I paid his medical bills, but it was no biggy since the total came to a little under $1,000, including the surgery and medicines. I can't even imagine what it would have costed in the US. Again, I want to emphasize that Tokyo is one of the most expensive cities in the world. This is not The Third World.

The propaganda in the USA is that providing medical coverage would somehow break the government and small companies, which is a load of bollocks. Americans are ALREADY paying beyond what the Japanese pay: you are just distributing it badly. It is going to a massive bureaucracy and a few mega-companies. The demise of the car industry in the USA is a great illustration of how providing a national health care plan is one of the most pro-business concepts imaginable. No one would lose from it.

Don2 (Don1 Revised)

May 21, 2007, 07:55 AM

...it would be very difficult; revolutionary changes often are.
It is not that revolutionary but could be comprised of merely a couple of small reforms.

Perhaps the most difficult part would be getting past the inevitable opposition that would come from those who benefit so much from the current system: pharmaceutical companies and insurers, for sure, and many doctors as well.
No, I am not talking nationalizing all of healthcare, but just a couple of small changes that gives everyone full coverage...like the way it works in Japan. BUT you are correct that there will be some opposition. Much of it will be from misunderstandings about the policy maybe even from the groups you have listed.

However, many other doctors clearly recognize that the American healthcare system is expensive, inefficient, and fails an ever-growing number of Americans. As medical costs continue to soar, the number of uninsureds continues to swell, and the US population continues to age, the collapse of the American healthcare system as it now stands seems inevitable.
True and hopefully these doctors would support some small reforms to guarantee everyone full coverage.

Something modeled after the Japanese system is certainly worthy of consideration.
I hope so, too. Maybe I do not know enough about it, but my impression (and the reason I posted the op) was that this could be something rational and achievable. However, the op has been met with typical argumentum ad Cuba from some.

Malcolm Kirkpatrick

May 21, 2007, 08:36 AM

Does anyone even read anymore? A universal healthcare system can and does, exist in parallel to a private system. Universal public healthcare is more efficient than private healthcare.The subsidized system will displace the unsubsidized system.Why must you resist the evidence?I don't believe that spacecraft piloted by intelligent extraterrestials visit Earth, either, despite shelves full of "evidence" (books by confused, sexually frustrated losers).

I don't have much experience with the US health care system (haven't been to a doctor in over 10 years), but I have seen how government institutions operate (over-staffed and slow), so I don't expect anything else from State-operated health care.

If the proposed policy is to subsidize care at private providers (Medicaid for everyone), what limits will there be on individual consumption? That is, can a homeless person check into a hospital claiming a headache whenever s/he needs a bed for the night? Subsidized goods are over-consumed.

Nitrousoxide

May 21, 2007, 09:22 AM

The go to the OECD (an organization for promoting market based reforms) and look at indicators for infant mortality, life expectancy and years lost to preventable disease. Socialized systems out perform the american system in every area at less than half the cost. The rankings of international systems is done by the OECD - they also audit systems for strengths and weaknesses, and advise nations on how to fix their medical, primary, secondary and post secondary education systems etc.

Did you not even read what I wrote? The numbers, whatever they are, are not comparable because the definitions for "live birth" and "still birth" differ in countries. This throws off both the "still births per 1000 births" numbers as well as the overall life expectancy numbers.

I'm basically reposting what I wrote before because you just ignored what I said, but preventable diseases are caused partly by the availability of medicine, but they are caused by lifestyle choices ranging from the sort of food one eats to how much one exercises. Unless you control for those lifestyle choices (which intranational, homogeneous states have little reason to do) you cannot compare the numbers. If it's primarily because of poor diet or exercise, having better available medicine will not change the instance rate substantially.

As for the efficiency argument, there are two paths one needs to consider in making the system more efficient, privatizing it or socializing it. Since we are in a mixed system right now, we can't just compare our current system to a socialized system and call the game for the socialized team. We must consider what reducing the amount of government intervention in the insurance industry would do for efficiency. I suspect that like all markets for a good which can reach perfect or near perfect competition, private industry will far exceed the efficiency of the government. And there's no reason to think that the insurance industry couldn't reach such a state of competition.

Metaphor

May 21, 2007, 09:44 AM

The subsidized system will displace the unsubsidized system.I don't believe that spacecraft piloted by intelligent extraterrestials visit Earth, either, despite shelves full of "evidence" (books by confused, sexually frustrated losers).

Dismissing studies in peer reviewed journals, and comparing the results to pseudoscience mumbo jumbo because they don't support your conclusions smacks of desperation.

I don't have much experience with the US health care system (haven't been to a doctor in over 10 years), but I have seen how government institutions operate (over-staffed and slow), so I don't expect anything else from State-operated health care.

If the proposed policy is to subsidize care at private providers (Medicaid for everyone), what limits will there be on individual consumption? That is, can a homeless person check into a hospital claiming a headache whenever s/he needs a bed for the night? Subsidized goods are over-consumed.

This too, is false. Subsidised health-care means people are more likely to go to the doctor when they have something wrong with them. Admittedly, this does represent more use than avoiding going when you can't afford it but need to. If anything, there are certain groups who need to visit doctors more often (particularly men).

I've never heard of a single report of the fantasy homeless scenario you've concocted, because it simply doesn't happen.

But hey - the private system in the US is great, right? You spend more than twice as much per head than any other Western nation, and at best you rank somewhere in the middle. See if I care.

:huh:

Styrofoamdeity

May 21, 2007, 09:59 AM

The subsidized system will displace the unsubsidized system.I don't believe that spacecraft piloted by intelligent extraterrestials visit Earth, either, despite shelves full of "evidence" (books by confused, sexually frustrated losers).

I don't have much experience with the US health care system (haven't been to a doctor in over 10 years), but I have seen how government institutions operate (over-staffed and slow), so I don't expect anything else from State-operated health care.

If the proposed policy is to subsidize care at private providers (Medicaid for everyone), what limits will there be on individual consumption? That is, can a homeless person check into a hospital claiming a headache whenever s/he needs a bed for the night? Subsidized goods are over-consumed.

Um, are you saying that the Japanese medical care system is "not real", like aliens visiting earth? I sure feel like I'm in a real place, with a real medical system, that really works, but if you believe this is some kind of vast delusion then maybe this is the Matrix or something, because it sure feels real.

It appears to me that the OP used an actual example of a real place, not some kind of far-fetched alien story, so frankly I can't see what in the heck you are talking about with your analogy of belief in aliens in visiting Earth.

Maybe you can elaborate about how the use of a real world example in the OP (and in my posts) is remotely equivalent to a belief in far-fetched things, such as aliens?

Nitrousoxide

May 21, 2007, 10:11 AM

But hey - the private system in the US is great, right? You spend more than twice as much per head than any other Western nation, and at best you rank somewhere in the middle. See if I care.

Why do you keep repeating false information? We've shown at least 3 times in this thread that the information used to derive that number is based on faulty comparisons. Our number is artifically decreased because of the differing definitions of live births and still births between us and Europe.

Lifestyle difference alter the health of a nation, and won't be altered by socialized medicine but like I've said some 2 times before, Europeans just tend to live healthier than Americans, increasing their numbers still further. This all without even considering the healthcare systems in the two nations.

You need to compensate for that information before you can make a qualified statement about the healthcare systems.

Metaphor

May 21, 2007, 10:20 AM

Why do you keep repeating false information? We've shown at least 3 times in this thread that the information used to derive that number is based on faulty comparisons. Our number is artifically decreased because of the differing definitions of live births and still births between us and Europe.

Lifestyle difference alter the health of a nation, and won't be altered by socialized medicine but like I've said some 2 times before, Europeans just tend to live healthier than Americans, increasing their numbers still further. This all without even considering the healthcare systems in the two nations.

You need to compensate for that information before you can make a qualified statement about the healthcare systems.

Actually, I was doing nothing of the kind. I have never seen a link detailing this difference in definition to begin with, but in any case you certainly can't say the US is better - the only evidence we have is that it is mediocre. One piece of information that is not disputed, however, is the per capita cost of the American system.

But even if we leave aside all health indicators, what makes you think the US system is somehow better than nationalised healthcare?

Nitrousoxide

May 21, 2007, 10:47 AM

Actually, I was doing nothing of the kind. I have never seen a link detailing this difference in definition to begin with, but in any case you certainly can't say the US is better - the only evidence we have is that it is mediocre. One piece of information that is not disputed, however, is the per capita cost of the American system.

But even if we leave aside all health indicators, what makes you think the US system is somehow better than nationalised healthcare?

How 'bout this?
http://www.smw.ch/docs/pdf200x/2005/29/smw-10946.PDF (http://www.smw.ch/docs/pdf200x/2005/29/smw-10946.PDF)

They judge that Switzerland is considerably underreporting their numbers by changing the definition. They report a 6.9% rate, but were it in line with other industrialized nations, it would be 8.0%.

And I don't need to provide evidence that the American system is better. I merely need to show that the evidence for change is unacceptable. If we are unsure about whether the system we would be changing to would be worse or better, we shouldn't be going around changing it anyway, so the debate should be put off until acceptable information can be gathered.

So don't try to pass the burden of proof to me, it's not in my hands as I'm not the affirmative.

Loren Pechtel

May 21, 2007, 10:55 AM

What about #1 in profit... #37 in performance!

The "study" that reported us as #37 was bad.

They *KNEW* the infant mortality data was bogus (it's mentioned in the footnotes) and yet used it anyway.

Loren Pechtel

May 21, 2007, 10:57 AM

Say it with me:

"Socialized single payer systems have lower infant mortality, higher life expectancy and less years lost to preventable disease at half the cost of the american medical system while providing universal coverage to all their citizens."

Continuing to repeat bad data won't make it true.

Infant mortality rates in industrialized nations have far more to do with what's defined as a live birth than the medical care they receive.

Loren Pechtel

May 21, 2007, 11:01 AM

Here's the problem with nationalized healthcare, especially the Canada model where private health insurance is not legal:

Poor folks: Nationalized health care is much better than no health care.

Rich folks: Nationalized health care is the same as private health care. They're rich enough to pay for whatever care they want.

Middle-class folks: Nationalized health care is far worse than private health care. You have waiting periods for treatment, you cannot see your chosen specialist, if you want to pay a higher co-pay to go to a better doctor you can't, some things (like epidurals for women giving birth) are not available on weekends, and if you have any rare, expensive-to-treat disease you're completely out of luck.

Yes, Canada gives better outcomes in aggregate. But for any specific middle-class person, the outcomes are likely to be worse or much worse.

Exactly.

Universal care helps the poor more than it hurts the middle class so it looks good when you examine the overall numbers.

Furthermore, most of those in middle class aren't sick in the first place and don't see the problems.

Loren Pechtel

May 21, 2007, 11:04 AM

Malcolm Kirkpatrick

May 21, 2007, 11:05 AM

(Metaphor): "Why must you resist the evidence?"
(malcolm): "I don't believe that spacecraft piloted by intelligent extraterrestials visit Earth, either, despite shelves full of "evidence" (books by confused, sexually frustrated losers)."
Dismissing studies in peer reviewed journals, and comparing the results to pseudoscience mumbo jumbo because they don't support your conclusions smacks of desperation.Peer reviewed? You mean like The Lancet (bogus statistics in Iraq mortality)? I haven't "dismissed" a single study; I haven't seen any.

It's not ""desperation". I just don't see how aggregating resorrces and decision-making authority into the hands of the goons with the guns (the State) improves services delivered by industries like education or medical care. In my mind, the "public goods" argument for State provision of charity (Medicaid, Food Stamps, etc.) fails, since oversight of State functions is a public good which the State itself cannot provide, obviously. "Charity begins at home" and it should end well below the State (government, generally). That's what voluntary fraternal associations (Elks, Shriners, etc.) are for.
I don't have much experience with the US health care system (haven't been to a doctor in over 10 years), but I have seen how government institutions operate (over-staffed and slow), so I don't expect anything else from State-operated health care.

If the proposed policy is to subsidize care at private providers (Medicaid for everyone), what limits will there be on individual consumption? That is, can a homeless person check into a hospital claiming a headache whenever s/he needs a bed for the night? Subsidized goods are over-consumed.This too, is false. Subsidised health-care means people are more likely to go to the doctor when they have something wrong with them. Admittedly, this does represent more use than avoiding going when you can't afford it but need to. If anything, there are certain groups who need to visit doctors more often (particularly men).I believe it was Lao Tzu who observed "The wise man does not need to live." Subsidized care means people will go to doctors for problems which they could handle themselves. It means people will go to doctors for no reason whatsoever. I've never heard of a single report of the fantasy homeless scenario you've concocted, because it simply doesn't happen.Never heard of welfare fraud or insurance fraud? Ummmmm, I find that unlikely.But hey - the private system in the US is great, right? You spend more than twice as much per head than any other Western nation, and at best you rank somewhere in the middle. See if I care.You evidently do.

Metaphor

May 21, 2007, 11:19 AM

How 'bout this?
http://www.smw.ch/docs/pdf200x/2005/29/smw-10946.PDF (http://www.smw.ch/docs/pdf200x/2005/29/smw-10946.PDF)

They judge that Switzerland is considerably underreporting their numbers by changing the definition. They report a 6.9% rate, but were it in line with other industrialized nations, it would be 8.0%.

And I don't need to provide evidence that the American system is better. I merely need to show that the evidence for change is unacceptable. If we are unsure about whether the system we would be changing to would be worse or better, we shouldn't be going around changing it anyway, so the debate should be put off until acceptable information can be gathered.

So don't try to pass the burden of proof to me, it's not in my hands as I'm not the affirmative.

Actually, the title is whether it is feasible or not. Clearly nationalised healthcare is feasible - in other Western nations.

Whether it is feasible or not in the US depends on the resistance of right wing hardliners who refuse to see the evidence all around them.

Nitrousoxide

May 21, 2007, 11:26 AM

What evidence? You keep asserting that there is evidence yet you've not presented any evidence which hasn't been undermined by improper mythology or bad data.

You're just proselytizing, not debating.

I mean, if you really want me to admit it, I will. Universal health care would be possible to implement to in the US. I've never doubted that though. It's like asking whether it would be possible to put spikes on the inside of a baby's crib. Sure, it's possible, but that doesn't mean it's a good idea.

So you really need to answer whether implementing it would be a good idea, not whether it would be possible.

Metaphor

May 21, 2007, 11:29 AM

(Metaphor): "Why must you resist the evidence?"
(malcolm): "I don't believe that spacecraft piloted by intelligent extraterrestials visit Earth, either, despite shelves full of "evidence" (books by confused, sexually frustrated losers)."
Peer reviewed? You mean like The Lancet (bogus statistics in Iraq mortality)? I haven't "dismissed" a single study; I haven't seen any.

It's not ""desperation". I just don't see how aggregating resorrces and decision-making authority into the hands of the goons with the guns (the State) improves services delivered by industries like education or medical care. In my mind, the "public goods" argument for State provision of charity (Medicaid, Food Stamps, etc.) fails, since oversight of State functions is a public good which the State itself cannot provide, obviously. "Charity begins at home" and it should end well below the State (government, generally). That's what voluntary fraternal associations (Elks, Shriners, etc.) are for.

If you just don't believe the state should be involved, then there is no evidence that is relevant as to the efficacy of the system. The efficacy won't matter to you. In the previous PD forum I posted links indicating that the public system in Australia is more efficient than the private system, but since you evidently don't think the state should do anything but quietly and with minimal fuss commit suicide, it won't matter.

I believe it was Lao Tzu who observed "The wise man does not need to live." Subsidized care means people will go to doctors for problems which they could handle themselves. It means people will go to doctors for no reason whatsoever. Never heard of welfare fraud or insurance fraud? Ummmmm, I find that unlikely.You evidently do.

Let's speculate until the cows come home. Or, better, let's actually look at COUNTRIES THAT ALREADY HAVE NATIONALISED MEDICINE.

Australia has nationalised medicine and there is not a crisis of improper use. Subsidised health care is nothing like a commodity that people would take and hoard. People are reluctant to see doctors as it is. The idea of visiting doctors unnecessarily strikes me as somewhat absurd in any case - only hypochondriacs would, and they're going to do that either way.

Would YOU go to see a doctor for no reason at all just because it was subsidised?

Where do you GET these fantasties?

Metaphor

May 21, 2007, 11:49 AM

What evidence? You keep asserting that there is evidence yet you've not presented any evidence which hasn't been undermined by improper mythology or bad data.

You're just proselytizing, not debating.

Cut and pasted from the old board:

http://www.awhn.org.au/content/view/34/84/

Above reports that TOTAL EXPENDITURE on health is MORE per capita in the USA (public + private) but Australia has better health care and a healthier population.

http://www.drs.org.au/new_doctor/75/davoren_75.html

The above reports on three separate studies indicating that the public system is more efficient than the private system.

http://www.drs.org.au/policies/policy04.htm

Most doctors in Australia support universal health coverage. I have not spoken to a single physician or surgeon who thinks otherwise.

In fact, Nitrous, the above post was made in response to one of your posts on the old board, and you never responded.

[COLOR=black][FONT=Verdana]
I mean, if you really want me to admit it, I will. Universal health care would be possible to implement to in the US. I've never doubted that though. It's like asking whether it would be possible to put spikes on the inside of a baby's crib. Sure, it's possible, but that doesn't mean it's a good idea.

So you really need to answer whether implementing it would be a good idea, not whether it would be possible.

Well, I think it would be a good idea, but, as I already volunteered on a previous post on the old PD board, I would be for it even if it were slightly less efficient than a fully private system.

Nitrousoxide

May 21, 2007, 12:13 PM

Cut and pasted from the old board:
http://www.awhn.org.au/content/view/34/84/

Above reports that TOTAL EXPENDITURE on health is MORE per capita in the USA (public + private) but Australia has better health care and a healthier population.

Again, let me once again bring up the fact that we don't yet have a way to compare different countries health indicators because of difference in definition. But, let's assume you were right that Australia has a healthier population. You must take into account non-healthcare related factors in that such as lifestyle choices. If a population has a healthier lifestyle, it can reduce health care costs substantially. So how does your study control for the reduction in health care costs caused by lifestyle decisions? Those lovely fast food restaurants that we Americans adore so much are going to raise the cost of health care regardless of whether we have a socialized system or a mixed system like we do now.

http://www.drs.org.au/new_doctor/75/davoren_75.html

The above reports on three separate studies indicating that the public system is more efficient than the private system.

No, what it indicates is that private policies which are taken out by individuals does not help the public hospitals. Hardly a shocking concept.

The main problems they are experiencing with difference in price are due to such pervasive government involvement, they aren't inherent to private insurance.

http://www.drs.org.au/policies/policy04.htm

Most doctors in Australia support universal health coverage. I have not spoken to a single physician or surgeon who thinks otherwise.

That doesn't mean it's a good idea.

Well, I think it would be a good idea, but, as I already volunteered on a previous post on the old PD board, I would be for it even if it were slightly less efficient than a fully private system.

That doesn't seem to make any sense, especially if the case for it producing a healthier society has not been made. The only two arguments I've seen from you are that it produces a healthier society and that it is more efficient. If neither of those is true, why support it?

Malcolm Kirkpatrick

May 21, 2007, 12:32 PM

... you evidently don't think the state should do anything but quietly and with minimal fuss commit suicide...That's not my position at all. I argue that organized violence (the State) has its place. It doesn't do education, medical care, retail sales, manufacture of consumer goods, or agriculture well.The idea of visiting doctors unnecessarily strikes me as somewhat absurd in any case - only hypochondriacs would, and they're going to do that either way.Subsidized goods are over-consumed. The line at the emergency room forms after 4:30, since the welfare cases don't like to wait in line at the free clinic and before 4:30 the emergency room staff will tell them to go to the free clinic. People vary in their enthusiasm for treatment. Doctors vary in their enthusiasm for fraud. Subsidized treatment raises participation at all levels.Would YOU go to see a doctor for no reason at all just because it was subsidised?There are lots of crimes I don't commit. That hardly means that no one does.

Hooboy !!

May 21, 2007, 12:48 PM

Let's see- Chrysler is almost bankrupt and other US automakers now have no chance of competing with foreign makers. Mainly because they are weighted down with gigantic health care costs
This is simply wrong. American automakers are falling behind their competition for a number of reasons including:

- Inefficient manufacturing facilities
- Slow from concept to market
- Simply failing to produce products buyers want

Costs such as healthcare, retirement, and labor are a part of the problem of course, but they are just a part of the bigger picture.

BTW, the easiest way to solve this problem? Stop offering employer based healthcare and retirement for that matter. It was a stupid ide to begin with, now would be a good time to do away with it.

Group insurance rates should not be limited to employers and private retirement programs would eliminate the problems with the shrinking ratio of workers to retirees.

Nice Squirrel

May 21, 2007, 12:52 PM

Malcolm Kirkpatrick

May 21, 2007, 02:33 PM

Subsidized goods are over-consumed. The line at the emergency room forms after 4:30, since the welfare cases don't like to wait in line at the free clinic and before 4:30 the emergency room staff will tell them to go to the free clinic.Do you have any evidence that this is true or is this mere speculation? And how would the hospital staff know if these people are on welfare or are part of the working poor?1. I dated a nurse. She told me.
2. The State pays for the care, so the hospital needs to know for billing purposes.What does your's and other's criminal activity/lack of it have to do with single-payer healthcare?Ask Metaphor. My point was, there are crooks on this planet.
Some people will commit outright fraud. Some will overconsume subsidized goods (a tragedy of the commons).
The relevant consideration is not "single-payer" but "universal" (implies subsidized). If 100 philanthropists each guaranteed to one percent of the US population treatment at any medical facility, and didn't monitor the type of treatment, why suppose that there would be any less fraud than if one very wealthy State agency subsidized care?

The reason it's the welfare cases who line up at the emergency room is that the emergency room is more expensive to people who are not on welfare, since the State pays for welfare cases while working people pay a fee (the deductable) even if they have insurance. Overconsumption of emergency room treatment by welfare recipients is an indication of what will happen with "universal" State-funded care when we are all on welfare (i.e., with passage of universal, taxpayer-subsidized care).

untermensche

May 21, 2007, 05:12 PM

America pays much more for healthcare than other places. Where does the money go in a private system where top executives can make over 100 million dollars a year?

Where does it go?

I wonder?

Dr Rick

May 21, 2007, 05:34 PM

1. I dated a nurse. She told me.If there was ever an honor roll for memorable responses when asked to provide evidence, surely this one belongs on it.2. The State pays for the care, so the hospital needs to know for billing purposes.A hospital does not need to know if a patient is a welfare recepient to bill state-financed medical programs.

Dr Rick

May 21, 2007, 05:40 PM

...Stop offering employer based healthcare...I agree

Malcolm Kirkpatrick

May 21, 2007, 05:50 PM

(Malcolm): "The line at the emergency room forms after 4:30, since the welfare cases don't like to wait in line at the free clinic and before 4:30 the emergency room staff will tell them to go to the free clinic."
(Nice Squirrel): "Do you have any evidence that this is true or is this mere speculation?"
(malcolm): "I dated a nurse. She told me."If there was ever an honor roll for memorable responses when asked to provide evidence, surely this one belongs on it.You mean, reports from people on the scene don't count as evidence? I aswered the squirrel's question. Got a problem with that?

(Nice Squirrel): "And how would the hospital staff know if these people are on welfare or are part of the working poor?"
(malcolm): "The State pays for the care, so the hospital needs to know for billing purposes."A hospital does not need to know if a patient is a welfare recepient to bill state-financed medical programs.The hospital neeeds to know which agency to bill. For self-employed people, it's their insurance company. For employees in the private sector, it's the insurance company to which their contract entitles them. Same for governmenmt employees. For welfare recipients, it's the instution which the State welfare agency designates. Yes, hospitals need to know how they are going to get paid.

laughing dog

May 21, 2007, 05:53 PM

Nitrousoxide

May 21, 2007, 05:55 PM

You mean, reports from people on the scene don't count as evidence? I aswered the squirrel's question. Got a problem with that?

Anecdotal evidence is shaky at best, and especially so in this case because no one can verify your claim.

Metaphor

May 21, 2007, 06:27 PM

Again, let me once again bring up the fact that we don't yet have a way to compare different countries health indicators because of difference in definition. But, let's assume you were right that Australia has a healthier population. You must take into account non-healthcare related factors in that such as lifestyle choices. If a population has a healthier lifestyle, it can reduce health care costs substantially. So how does your study control for the reduction in health care costs caused by lifestyle decisions? Those lovely fast food restaurants that we Americans adore so much are going to raise the cost of health care regardless of whether we have a socialized system or a mixed system like we do now.

It is clear you aren't going to accept any public heath indicators. What is not clear to me is what would count - for you - as a true indicator. You seem to think that Americans are just too fat to be compared to any other Western nation - but WHY should obesity be controlled for, if medicine gives people options to manage it? To begin with, the drug sibutramine is much cheaper in Australia than the US, partly because of our national system of subsidised drugs that brings down prices in general.

[SIZE=3][FONT=Times New Roman]No, what it indicates is that private policies which are taken out by individuals does not help the public hospitals. Hardly a shocking concept.

Since you clearly DID NOT READ THE ARTICLE, I will reproduce the relevant paragraphs:

Three recent articles in the Medical Journal of Australia clearly demonstrate the fallacy that private medicine is good for the public purse. The first study (Duckett and Jackson 2000) compared the efficiency of public and private hospitals taking casemix into account. Technical, allocative and dynamic efficiency criteria were examined using data on hospitals from the National Cost Weight Study. The conclusion was that hospital care in the public sector is provided at higher levels of efficiency than in the private sector.

The second study examined how public and private patients in Victoria were investigated and treated if they presented to hospital with a heart attack during the mid 1990s (Robertson and Richardson 2000). Bypass surgery rates were similar in the two groups but privately insured patients were twice as likely to undergo coronary angiography and three times as likely to undergo balloon procedures. The findings suggest over-servicing in the private sector is the more likely explanation of the differences rather than under-servicing in the public sector.

The third study demonstrated that private patients can cost the government more money than public ones for the same procedure (Harper et al 2000). The cost of performing angioplasty and stenting of coronary arteries in a public patient in a public hospital is about $5,600. In contrast, the same procedure performed in the same room with the same equipment and the same technical and nursing staff on a private patient from the private hospital next door is $13,300! Further, the researchers estimated the cost of such a procedure in a typical private hospital and determined the public contribution to the expenses via Medicare payments and the cost of drugs. They discovered the cost to the public purse was $500 more for a private patient compared with the costs in the public system.

That doesn't seem to make any sense, especially if the case for it producing a healthier society has not been made. The only two arguments I've seen from you are that it produces a healthier society and that it is more efficient. If neither of those is true, why support it?

Well apparently you will never accept 1) and you have selective illiteracy for 2).

I support it because I think rich nations should provide a minimum level of welfare for its citizens regardless of ability to pay.

Metaphor

May 21, 2007, 06:29 PM

Subsidized goods are over-consumed.

Keep saying that. maybe it is true for healthcare....in an alternate universe.

Dr Rick

May 21, 2007, 07:16 PM

(Malcolm): "The line at the emergency room forms after 4:30, since the welfare cases don't like to wait in line at the free clinic and before 4:30 the emergency room staff will tell them to go to the free clinic."
(Nice Squirrel): "Do you have any evidence that this is true or is this mere speculation?"
(malcolm): "I dated a nurse. She told me."You mean, reports from people on the scene don't count as evidence? I aswered the squirrel's question. Got a problem with that?Just a small one; it has something to do with the fact that your assertions are complete and utter nonsense; they illustrate how unreliable hearsay anecdotes such as yours can be. For instance:(Nice Squirrel): "And how would the hospital staff know if these people are on welfare or are part of the working poor?"
(malcolm): "The State pays for the care, so the hospital needs to know for billing purposes...For welfare recipients, it's the instution which the State welfare agency designates.Welfare doesn't pay hospitals, nor do hospitals bill welfare. Welfare payments and credits go to individuals, not hospitals.

You are clearly and inexplicably conflating welfare with government health insurance programs; many individuals are on one but not the other. The former in the US is the Temporary Assistance for Needy Families (TANF), which replaced Aid to Families with Dependent Children (AFDC) with the Welfare Reform Act passed in the late 1990's. State run insurances for non-military personel such as Medicaid, on the other hand, are state and federal government funded health insurance programs for those on low incomes. Hospitals can try to collect money from state run insurances such as Medicaid, but they do not bill welfare.

But all may not have been lost; perhaps your date with this nurse was a lucky one.

Malcolm Kirkpatrick

May 21, 2007, 10:03 PM

(malcolm): "Subsidized goods are over-consumed."
Keep saying that. maybe it is true for healthcare....in an alternate universe.In this universe, the Soviet Union collapsed. In this universe, socialism failed. In this universe, across commodities and services, consumption rises as costs fall. Subsidies reduce apparent costs to consumers. Indeed, if subsidies didn't increase consumption, what would be the point?

...Welfare doesn't pay hospitals, nor do hospitals bill welfare. Welfare payments and credits go to individuals, not hospitals...I did not say that the hospital billed the same agency which supplies rent subsidies or infant nutrition subsidies. I said that a State agency (in Hawaii, anyway) pays hospital bills for welfare recipients. Hospitals collect from conscious walk-ins information which determines whom to charge for care. That is how my friend (an emergency room nurse) knew that the people who joined the line for e-r treatment after 4:30 were welfare recipients.

PS. It's not the case that section 8 housing vouchers "go to individuals", anymore (or less) than medicaid vouchers "go to individuals". Housing vouchers go to landlords, which can be institutions. Medicaid vouchers go to medical service providers, which can be physicians or instutions like hospitals.

Don2 (Don1 Revised)

May 21, 2007, 10:59 PM

(malcolm): "Subsidized goods are over-consumed."
Can you explain how healthcare in Japan is "over-consumed"?

In this universe, the Soviet Union collapsed. In this universe, socialism failed. In this universe, across commodities and services, consumption rises as costs fall. Subsidies reduce apparent costs to consumers. Indeed, if subsidies didn't increase consumption, what would be the point?
I thought Reagan caused the Soviet Union to collapse? I mean, it's very easy to lose track these days of what caused the collapse of the Soviet Union with all the political spin involved. If you want to talk about it, I suggest you start a different thread because this one is about Japan which is much more like the US than the USSR.

I did not say that the hospital billed the same agency which supplies rent subsidies or infant nutrition subsidies. I said that a State agency (in Hawaii, anyway) pays hospital bills for welfare recipients. Hospitals collect from conscious walk-ins information which determines whom to charge for care. That is how my friend (an emergency room nurse) knew that the people who joined the line for e-r treatment after 4:30 were welfare recipients.

PS. It's not the case that section 8 housing vouchers "go to individuals", anymore (or less) than medicaid vouchers "go to individuals". Housing vouchers go to landlords, which can be institutions. Medicaid vouchers go to medical service providers, which can be physicians or instutions like hospitals.
Can you please explain what the heck your gross generalizations about what hours "welfare cases" like to frequent the emergency rooms at hospitals has to do with full coverage in Japan working?

Metaphor

May 22, 2007, 02:23 AM

(malcolm): "Subsidized goods are over-consumed."
In this universe, the Soviet Union collapsed. In this universe, socialism failed. In this universe, across commodities and services, consumption rises as costs fall. Subsidies reduce apparent costs to consumers. Indeed, if subsidies didn't increase consumption, what would be the point?

I notice a subtle change here. Yes, subsidised medicine would probably increase consumption. But how does this mean it is overconsumption?

Is someone going to the doctor who couldn't afford to do so before overconsumption? Do you even realise how absurd it is to say you can overconsume health services?

You also previously claimed that although YOU wouldn't overconsume, people in general would. Care to explain this elitist fantasy?

coloradoatheist

May 22, 2007, 02:43 AM

I notice a subtle change here. Yes, subsidised medicine would probably increase consumption. But how does this mean it is overconsumption?

Is someone going to the doctor who couldn't afford to do so before overconsumption? Do you even realise how absurd it is to say you can overconsume health services?

You also previously claimed that although YOU wouldn't overconsume, people in general would. Care to explain this elitist fantasy?

You certainly can overconsume it and it happens hen you look at the waiting rooms in ERs where people go now for all types of ailments. It creates long waiting lines. The solution has to be designed so that doesn't happen. Also all the countries of UK, New Zealand for example have long waiting times for non-emergency surgeries.

Question about Japan, what percentage of the population is overweight?

Mike

Canard DuJour

May 22, 2007, 03:03 AM

I dated a nurse. She told me.I dated her friend who told me she's a liar.

Subsidized goods are over-consumed.Yeah. Just last week I suckered the NHS into giving me chemotherapy. Hee hee!

Metaphor

May 22, 2007, 03:06 AM

Yeah. Just last week I suckered the NHS into giving me chemotherapy. Hee hee!

Score!!

Not only do you get to feel violently ill, you've consumed thousands of dollars of pills just to spite the right wing. Way to go!

Metaphor

May 22, 2007, 03:09 AM

coloradoatheist

May 22, 2007, 03:38 AM

But are you defining overconsumption just because there are longer waiting lines? Why? I have to wait to get on the bus during peak hour, is public transport overconsumed?

Is there some crisis unfolding where people go to emergency for a headache? What's your evidence? And why isn't the triage nurse turning these people away?

Do you think that socialised medicine forces hospitals to attend to frivolous cases? Where do you get this delusion?

In the US yes because people without insurance go there and it has tied up resources and because they have to accept them it raises the costs for everyone. So yes, waiting times in both seeing a doctor and then getting surgery are from overconsumption.

Mike

Metaphor

May 22, 2007, 03:47 AM

In the US yes because people without insurance go there and it has tied up resources and because they have to accept them it raises the costs for everyone. So yes, waiting times in both seeing a doctor and then getting surgery are from overconsumption.

Mike

First, that isn't overconsumption. That is treating a problem at the cheapest place possible.

Second, that sounds like an argument FOR universal healthcare, not against it.

Styrofoamdeity

May 22, 2007, 04:10 AM

You certainly can overconsume it and it happens hen you look at the waiting rooms in ERs where people go now for all types of ailments. It creates long waiting lines. The solution has to be designed so that doesn't happen. Also all the countries of UK, New Zealand for example have long waiting times for non-emergency surgeries.

Question about Japan, what percentage of the population is overweight?

Mike

Colorado Atheist, not many Japanese are overweight, but a much higher percentage of them are old than in America. Further the rate of smoking is higher in Japan. Until recently the rate for men was in the area of 50%. Yet virtually no waiting times in hospitals like the USA and none of the impenetrable bureaucracy. Further Japanese notoriously go to the hospital for trivial stuff, such as bad colds, flu, and sore muscles. Even if you wander in with a minor ailment, with no appointment, you are unlikely to be waiting up for more than an hour or so. Japanese visit hospitals MORE than Americans do, but the system can absorb the visits due to the large number of clinics and because of the lack of overweening bureaucracy.

Americans are unhealthy for their weight, for sure, but Japanese are unhealthy for their higher average age and for higher rates of smoking, so the weight issue is a bit of a red herring. I don't understand what you are driving at. Each country has its own set of high risk behaviors, and America is not unique for having some of its own.

The excellent care system in Japan is without a doubt one of the reasons that Japanese live longer than other countries, including their neighbors who share virtually the same genetics. The diet here is healthy, but so is the diet of other Asian countries and they don't live nearly as long as the Japanese do. The critical difference is full medical coverage where everyone has access to excellent and affordable medical care.

Having personally experienced both systems, I thank my lucky stars I don't have to go through the nonsense you do in America. I simply cannot understand why anyone is buying the propaganda about the "problems" of socialized medicine anymore. I'm no socialist, I'm just a person who has gone through both systems and seen them with my own eyes.

untermensche

May 22, 2007, 04:13 AM

But are you defining overconsumption just because there are longer waiting lines? Why? I have to wait to get on the bus during peak hour, is public transport overconsumed?

Is there some crisis unfolding where people go to emergency for a headache? What's your evidence? And why isn't the triage nurse turning these people away?

Do you think that socialised medicine forces hospitals to attend to frivolous cases? Where do you get this delusion?
It is only these type delusions that can justify deliberate cruelties.

Just as the US was very late in recognizing the need to abolish slavery, it is very late in recognizing many fundamentals of modern industrial society. The enlightened nations, in terms of formulating a just society, have long ago recognized access to healthcare, before the emergency level, is a good the government can provide.

The fact is, the US could provide it better than any other nation has so far.

If it wanted to.

Metaphor

May 22, 2007, 04:31 AM

It is only these type delusions that can justify deliberate cruelties.

Just as the US was very late in recognizing the need to abolish slavery, it is very late in recognizing many fundamentals of modern industrial society. The enlightened nations, in terms of formulating a just society, have long ago recognized access to healthcare, before the emergency level, is a good the government can provide.

The fact is, the US could provide it better than any other nation has so far.

If it wanted to.

Well, it was only about 100 years behind Europe in abolishing slavery. So maybe give the US a few more decades, and it'll decide perhaps nationalised medicine isn't the Great Satan.

coloradoatheist

May 22, 2007, 05:45 AM

It is only these type delusions that can justify deliberate cruelties.

Just as the US was very late in recognizing the need to abolish slavery, it is very late in recognizing many fundamentals of modern industrial society. The enlightened nations, in terms of formulating a just society, have long ago recognized access to healthcare, before the emergency level, is a good the government can provide.

The fact is, the US could provide it better than any other nation has so far.

If it wanted to.

It's interesting that you bring up slavery since you want to put in a system of slavery in place in that I'm forced to work for your benefit. How much of my paycheck can be taken before you would consider it slavery, 50%, 75%, 100% or even if it's 10%?

Mike

People around the world are very lucky that most of health care services can travel easily around the world because most countries get subsized from the US but get the credit.

Mike

cape_royds

May 22, 2007, 05:57 AM

you cannot see your chosen specialist, if you want to pay a higher co-pay to go to a better doctor you can't, some things (like epidurals for women giving birth) are not available on weekends, and if you have any rare, expensive-to-treat disease you're completely out of luck.

Wrong. You have your choice both of GP and specialist in Canada. You can also go to any clinic or hospital. Most health care services are delivered privately in Canada--it's the health insurance system that is publicly-run and universal.

That freedom of choice is a big reason why Canada's health care is second only to the United States in health care costs (although it's a distant second). Canadians have more choice of providers than many Americans do with some HMO's.

We have one insurance payer, but many health providers. Same services, less administrative bloat and less many going to brokers and lawyers. That's how we preserve considerable choice, but at lower cost. And we keep almost everyone insured while we're at it.

Canada gives better outcomes in aggregate.

True. And that's with an ethnically-diverse society every bit as fat and as sedentary as yours! For those overall better results we pay considerably less--and we have fewer legal and bureaucratic hassles, too.

Aggregates are important. Better aggregates mean better experiences for more people, more often.

Finally, your point that there is a class differential effect on universal health care is a reasonable one, but you get the dividing lines wrong. Your argument that most of the middle-class is worse off is simply incorrect.

My "dividing lines" would go about as follows:

--50% clearly better off with universal public health care.
--30% about the same either way.
--20% clearly better off without universal public health care.

Individual median income in Canada is about $30,000 USD and there's no question that someone at that income is better off with the universal public-funded system. I happen to make close to the Canadian median income. I've gone online pricing US private health insurance and it all costs considerably more than a median Canadian like me would pay in federal and provincial taxes towards universal public health care.

Moreover those US private plans include conditions and complexities that no Canadian ever has to endure. Reading some of them over, I wondered "how and why do Americans put up with all this bullshit?"

Canard DuJour

May 22, 2007, 06:15 AM

People around the world are very lucky that most of health care services can travel easily around the world because most countries get subsized from the US but get the credit.

Mike

False (http://www.bmj.com/cgi/content/full/331/7522/958).

untermensche

May 22, 2007, 06:20 AM

It's interesting that you bring up slavery since you want to put in a system of slavery in place in that I'm forced to work for your benefit. How much of my paycheck can be taken before you would consider it slavery, 50%, 75%, 100% or even if it's 10%?

Mike

People around the world are very lucky that most of health care services can travel easily around the world because most countries get subsized from the US but get the credit.

Mike
The problem is taxation within an unjust system, where power is so unevenly divided, and therefore some are able to evade their tax responsibilities far more easily than others.

That is why you cry about the injustice of taxation.

In a fair and just economic system, where one person could not legally profit from the labor of another, taxation would be fair and just also.

Until then we have to deal with the injustices of what some call capitalism, even though many many things have been called and are still called capitalism, and it is a word that has no real definition. It is more a religious concept than any description of human economic activity. And like many religions, it has the faithful.

And one of the gross injustices of so-called capitalism that must be addressed in the US is the disparity in access to medical treatment. In effect the injustice of some having more worth than others, imposed through the force of the state.

coloradoatheist

May 22, 2007, 06:20 AM

False (http://www.bmj.com/cgi/content/full/331/7522/958).

Not false, Canada's health care expense and drug expenditure would come now where near providing enough if we had to rely on it.

Easy scenerio.....Let's not allow cross-border information flow and then really compare health care systems.

Mike

coloradoatheist

May 22, 2007, 06:30 AM

The problem is taxation within an unjust system, where power is so unevenly divided, and therefore some are able to evade their tax responsibilities far more easily than others.

That is why you cry about the injustice of taxation.

In a fair and just economic system, where one person could not legally profit from the labor of another, taxation would be fair and just also.

Until then we have to deal with the injustices of what some call capitalism, even though many many things have been called and are still called capitalism, and it is a word that has no real definition. It is more a religious concept than any description of human economic activity. And like many religions, it has the faithful.

And one of the gross injustices of so-called capitalism that must be addressed in the US is the disparity in access to medical treatment. In effect the injustice of some having more worth than others, imposed through the force of the state.

Yeah, let's go back to medicine pre modern capitalism. Can you name a society pre modern capitalism that provided health care for everyone?

Mike

untermensche

May 22, 2007, 06:34 AM

The United States already has a very good, yet somewhat corrupted, national health insurance. It is only for people over a certain age though.

This is clearly government descrimination.

Clearly unequal treatment, and clearly unconstitutional because of that.

But what does the Constitution matter when there are profits to be squeezed from a private insurance industry?

untermensche

May 22, 2007, 06:35 AM

Yeah, let's go back to medicine pre modern capitalism. Can you name a society pre modern capitalism that provided health care for everyone?

Mike
You use capitalism as if it were one thing and had some agree upon starting point.

The slave holders in the South were capitalists.

coloradoatheist

May 22, 2007, 06:39 AM

coloradoatheist

May 22, 2007, 06:40 AM

You use capitalism as if it were one thing and had some agree upon starting point.

The slave holders in the South were capitalists.

modern capitalism's starting point is the recognition of a corporation as a person.

Mike

laughing dog

May 22, 2007, 07:12 AM

Providing health care at the Federal level is unconstitutional in itself, not a power granted to Congress.

Mike
I'm not a lawyer or a constitutional scholare but the phrase in the preamble "promote the general welfare" seems to contradict your claim.

coloradoatheist

May 22, 2007, 07:21 AM

I'm not a lawyer or a constitutional scholare but the phrase in the preamble "promote the general welfare" seems to contradict your claim.

Should ask the FF that one, but provide and promote had different connotations. And none of the powers listed to Congress included making sure everyone was fed and had access to a doctor.

Mike

Metaphor

May 22, 2007, 07:25 AM

No responses contesting my links showing public healthcare is more efficient than private healthcare?

Nitrousoxide

May 22, 2007, 07:27 AM

No responses contesting my links showing public healthcare is more efficient than private healthcare?

I'll get to it sometime after work.

laughing dog

May 22, 2007, 07:35 AM

Should ask the FF that one, but provide and promote had different connotations. And none of the powers listed to Congress included making sure everyone was fed and had access to a doctor.

Mike
Dead men don't talk. The Constitution is not a static document. If welfare and social security are constitutional, so would be universal health care at the Federal level.

untermensche

May 22, 2007, 09:36 AM

Providing health care at the Federal level is unconstitutional in itself, not a power granted to Congress.

Mike
There are many ways to run an insurance system.

One way is in the interest of the health of the people in a society.

Another is to make it possible for some to profit greatly over what is a human inevitability, sickness and disability.

These two mindsets will create completely different systems, and the desire to profit over human sickness will inevitably lead to many not being able to afford health insurance.

The health insurance industry did not care much that the government took over the segment of greatest risk and greatest cost to leave them the segment with fewest costs and greatest chance of profit if the proper exclusions are made.

As far as Constitutional power of the Federal government to run a health insurance program, we have the 40+ year history of Medicare and that program is not threatened by the SC, nor would it be without serious consequences.

Ultimately the will of the people means something in a democracy.

Loren Pechtel

May 22, 2007, 09:58 AM

Not false, Canada's health care expense and drug expenditure would come now where near providing enough if we had to rely on it.

Easy scenerio.....Let's not allow cross-border information flow and then really compare health care systems.

That's going too far. How about my proposal, though? It eliminates the free-rider problem and yet doesn't curtail trade.

A simple rule: Any given drug must be sold at the same price to all customers. (Exceptions: Medicine donated free or at marginal cost, so long as this isn't a means of skirting the rules.) Prices can change but they can reverse only once in any 90 day window. (So you can't play the game of dropping the price while selling to X.)

Malcolm Kirkpatrick

May 22, 2007, 02:10 PM

...Do you even realise how absurd it is to say you can overconsume health services?...It's a beautiful day out, there's an eight foot swell runniong with off-shore winds. I can either go surfing or visit the doctor for this paper cut on my finger. If I visit the doctor, that's over-consumption of health sevices. So long as there is any other good in the universe that is not "health services", it's possible to over-consume health services.You also previously claimed that although YOU wouldn't overconsume, people in general would. Care to explain this elitist fantasy?Provide quotes; I don't recall making these assertions. I said "subsidized goods are over-consumed." I observed that welfare cases waited until after the free clinic had closed so as to get into a shorter line in the emergency room. People who must pay a high copayment will not use the ER for ailments which non-emergency services can treat. It's those whose costs are subsidized who overconsume.

Years ago, when I was marginally employed, I would purchase health insurance only for the winter months, when there's surf on the North Shore. Since I'm almost never ill, I was more likely to need medical care for sprains, fractures, and lacerations. I have a couple of wide scars from bouncing off the bottom at Off-The-Wall and Log Cabins, from wounds which I didn't have stitched because I wasn't insured at the time. I would have other visible scars except that the wounds were stitched, when I was insured.

I'd suggest that somewhere close to 1/2 of all resources devoted to medial care are wasted, because they are spent on people in the lst six months of life. People would be less likely to spend the money required to command these resources if they came out of their kids' inheritance or the grandkids' college tuition fund. Because they come from --other people's-- kids' inheritance, they don't mind. --That's-- overconsumption.

Dr Rick

May 22, 2007, 05:59 PM

I observed that welfare cases waited until after the free clinic had closed so as to get into a shorter line in the emergency room.Did you ever come-up with any evidence to back-up this assertion, or are you still stuck arguing what you heard from an old girlfriend?

Since you now know that hospitals don't bill welfare for their services, how do you know that these were "welfare cases" as opposed to say, the working poor who often rely on state-funded insurances such as medicaid? How do you know that they definitely did not go to the ER later in the day because they were at work during the hours when the "free clinic" was open? How do you know that they didn't have to wait until their kids were out of school and home before they could take them to the ER?

Malcolm Kirkpatrick

May 22, 2007, 07:09 PM

(malcolm): "...welfare cases waited until after the free clinic had closed so as to get into a shorter line in the emergency room."Did you ever come-up with any evidence to back-up this assertion, or are you still stuck arguing what you heard from an old girlfriend?There's a lemon tree in the backyard. Sorry I can't shove a branch through the screen to prove it. It's an anecdote, but illustrative: why --wouldn't-- the world work this way, given rational self-interest? ...how do you know that these were "welfare cases" as opposed to say, the working poor who often rely on state-funded insurances such as medicaid? How do you know that they definitely did not go to the ER later in the day because they were at work during the hours when the "free clinic" was open? How do you know that they didn't have to wait until their kids were out of school and home before they could take them to the ER?This argument is going in circles.

Reducing costs to consumers raises consumption. Subsidized goods are overconsumed. In Hawaii, a State agency pays the tab for medical services to welfare recipients. The hospital collects from conscious walk-in patients information that they need, to determine whom to bill. People whose care is covered by employers' insurance or insurance which they themselves purchase must usually pay some fraction of the bill. For people who will pay part of the bill, there is a strong incentive to avoid expensive ER care in non-imergency situations. This consideration is lacking in the calculation made by people whose bill is covered 100% by taxpayers.

Metaphor

May 22, 2007, 07:11 PM

I said "subsidized goods are over-consumed." I observed that welfare cases waited until after the free clinic had closed so as to get into a shorter line in the emergency room. People who must pay a high copayment will not use the ER for ailments which non-emergency services can treat. It's those whose costs are subsidized who overconsume.

First, you seem to be distinguishing between subsidised ER visits versus non-subsidised GP visits. Most GP visits in Australia are free, so cost would not be a discriminating factor.

Also, the triage nurse should either give you a 2c bandage and tell you to fuck off, or simply tell you to fuck off.

Provide quotes; I don't recall making these assertions.

Sigh. Are you an automaton, with no awareness of your own responses?

I wrote:

Originally Posted by Metaphor
Would YOU go to see a doctor for no reason at all just because it was subsidised?

You replied:
There are lots of crimes I don't commit. That hardly means that no one does.

If that isn't a claim that you don't commit the 'crime' of overconsumption whilst others do, then I am very much mistaken about the plain meaning of English words.

I'd suggest that somewhere close to 1/2 of all resources devoted to medial care are wasted, because they are spent on people in the lst six months of life. People would be less likely to spend the money required to command these resources if they came out of their kids' inheritance or the grandkids' college tuition fund. Because they come from --other people's-- kids' inheritance, they don't mind. --That's-- overconsumption.

Please continue to concoct imagined fantasies about how health services are overconsumed, lord knows you don't actually have data.

Dr Rick

May 22, 2007, 07:46 PM

This argument is going in circles.In the complete absence of any objective, verifiable evidence on your part, it's going nowhere.There's a lemon tree in the backyard. Sorry I can't shove a branch through the screen to prove it. It's an anecdote, but illustrative:Your claim about your lemon tree does not contradict facts and so is non-controversial; no one needs to see your lemon tree to know that your claim is not inconsistent with reality. Your claim about those whose healthcare is paid by the state, however, and which you erroneously persist in calling "welfare recepients," does contradict facts. The majority of those covered by medicaid live in households in which at least one person or more is working full-time, often at or close to minimum wage. They are gainfully employed yet still impoverished.In Hawaii, a State agency pays the tab for medical services to welfare recipients.It's administered by the Department of Human Services, and its programs, as in most states, are jointly funded by both the state and the federal government. And as in most states, it covers many people who are employed full time (a.k.a. the "working poor")The hospital collects from conscious walk-in patients information that they need, to determine whom to bill.Correct, but that still doesn't explain how your girlfriend, who you say worked in an ER as a nurse, would have anything to do with that information. ER Nurses don't bill patients and aren't the ones who collect billing information from patients when they come to the hospital.People whose care is covered by employers' insurance or insurance which they themselves purchase must usually pay some fraction of the bill. For people who will pay part of the bill, there is a strong incentive to avoid expensive ER care in non-imergency situations. This consideration is lacking in the calculation made by people whose bill is covered 100% by taxpayers.Now you've gone from using the hearsay anecdote from an old girlfriend to conjecture. Both arguments share in common the unfortunate trait of being completely devoid of any objective, verifiable evidence; in other words, they aren't good arguments.

Nitrousoxide

May 22, 2007, 09:33 PM

It is clear you aren't going to accept any public heath indicators. What is not clear to me is what would count - for you - as a true indicator. You seem to think that Americans are just too fat to be compared to any other Western nation - but WHY should obesity be controlled for, if medicine gives people options to manage it? To begin with, the drug sibutramine is much cheaper in Australia than the US, partly because of our national system of subsidised drugs that brings down prices in general.

Oh, I would accept public health indicators. There are some basic, common sense requirements that need to be met first though. The stats being studied need to have the same definition in each nation. Right now, the problems with the stillbirth rate and life expectancy rates are exactly like what you would find if you had one nation which classified “babies” as humans less than 1 year old, and another which classified “babies” as being less than 2 years old and tried to compare death rates between them.

Another factor which needs to be controlled for is the lifestyle choices. Leaving those in as variables makes the comparison about as acceptable as taking two weights, and drilling a hole and putting a floatation device from one company (A) on one, then putting a floatation device from a different company (B) on the other. You can’t claim that company “A” has a better floatation device based on that experiment because of other variables involved which skew the result.

Three recent articles in the Medical Journal of Australia clearly demonstrate the fallacy that private medicine is good for the public purse. The first study (Duckett and Jackson 2000) compared the efficiency of public and private hospitals taking casemix into account. Technical, allocative and dynamic efficiency criteria were examined using data on hospitals from the National Cost Weight Study. The conclusion was that hospital care in the public sector is provided at higher levels of efficiency than in the private sector.

The third study demonstrated that private patients can cost the government more money than public ones for the same procedure (Harper et al 2000). The cost of performing angioplasty and stenting of coronary arteries in a public patient in a public hospital is about $5,600. In contrast, the same procedure performed in the same room with the same equipment and the same technical and nursing staff on a private patient from the private hospital next door is $13,300! Further, the researchers estimated the cost of such a procedure in a typical private hospital and determined the public contribution to the expenses via Medicare payments and the cost of drugs. They discovered the cost to the public purse was $500 more for a private patient compared with the costs in the public system.

On these, two, I’m going to need some clarification as to how free your private sector in your country really is. How much regulation has been levied on them? The more government involvement in the private sector, the less efficient it tends to be. It’s even possible to use government involvement to make the private sector LESS efficient than the government by means of regulation one needs to follow but the other not.

The second study examined how public and private patients in Victoria were investigated and treated if they presented to hospital with a heart attack during the mid 1990s (Robertson and Richardson 2000). Bypass surgery rates were similar in the two groups but privately insured patients were twice as likely to undergo coronary angiography and three times as likely to undergo balloon procedures. The findings suggest over-servicing in the private sector is the more likely explanation of the differences rather than under-servicing in the public sector.

I’ll admit, I’m somewhat confused on this one. Correct me if I’m wrong, but aren’t angio and balloon procedures LESS dangerous than traditional open heart surgery? How is the more prevalent use of a less dangerous procedure to treat the same condition a symptom of an inefficient system? It’s it the exact opposite? Doesn’t it indicate that the government system is slow to change it’s treatments to accept newer and better techniques?

I support it because I think rich nations should provide a minimum level of welfare for its citizens regardless of ability to pay.

And I disagree.

Malcolm Kirkpatrick

May 22, 2007, 09:39 PM

(malcolm): "I said 'subsidized goods are over-consumed.' I observed that welfare cases waited until after the free clinic had closed so as to get into a shorter line in the emergency room. People who must pay a high copayment will not use the ER for ailments which non-emergency services can treat. It's those whose costs are subsidized who overconsume."
First, you seem to be distinguishing between subsidised ER visits versus non-subsidised GP visits. Most GP visits in Australia are free, so cost would not be a discriminating factor.That''s the point; glad to get some agreement. Both ER and the free clinic are "free" to welfare recipients. While the clinic is open, ER staff will tell welfare recipients with non-emergency conditions to go to the free clinic. After the free clinic closes, if they walk into the ER, the ER will treat them. They avoid the lines at the free clinic by waiting until it closes and using Emergency care. People to whom neither standard care nor ER care is free will take into consideration the added cost of the ER.Also, the triage nurse should either give you a 2c bandage and tell you to fuck off, or simply tell you to fuck off.I've reached that conclusion.

(Metaphor): "You also previously claimed that although YOU wouldn't overconsume, people in general would."
(malcolm): "Provide quotes; I don't recall making these assertions."
Sigh. Are you an automaton, with no awareness of your own responses?

I wrote:Would YOU go to see a doctor for no reason at all just because it was subsidised?
You replied:
There are lots of crimes I don't commit. That hardly means that no one does."

If that isn't a claim that you don't commit the 'crime' of overconsumption whilst others do, then I am very much mistaken about the plain meaning of English words.Let's take a bit more of the earlier exchange:...
(malcolm): "...People vary in their enthusiasm for treatment. Doctors vary in their enthusiasm for fraud. Subsidized treatment raises participation at all levels."
(Metaphor):"...The idea of visiting doctors unnecessarily strikes me as somewhat absurd in any case - only hypochondriacs would, and they're going to do that either way. Would YOU go to see a doctor for no reason at all just because it was subsidised? Where do you GET these fantasties?"
(malcolm)"There are lots of crimes I don't commit. That hardly means that no one does."

1. I don't believe I overconsume health care. I do vary in my consumprion depending on whether I have insurance or not.
2. Some people will run to the doctor for wounds that others will just wash with soap and H2O2. Some doctors are happy to run up the bill.
3. There are crooks in this world.

I did not say "people in general would" (overconsume). I said subsidization raises participation at all levels.

(malcolm): "I'd suggest that somewhere close to 1/2 of all resources devoted to medial care are wasted, because they are spent on people in the last six months of life. People would be less likely to spend the money required to command these resources if they came out of their kids' inheritance or the grandkids' college tuition fund. Because they come from --other people's-- kids' inheritance, they don't mind. --That's--overconsumption."Please continue to concoct imagined fantasies about how health services are overconsumed, lord knows you don't actually have data.I wondered how long civility was going to last in this new forum.

Malcolm Kirkpatrick

May 22, 2007, 10:09 PM

(Dr. Rick): "...how do you know that these were "welfare cases" as opposed to say, the working poor who often rely on state-funded insurances such as medicaid? How do you know that they definitely did not go to the ER later in the day because they were at work during the hours when the "free clinic" was open? How do you know that they didn't have to wait until their kids were out of school and home before they could take them to the ER?"
(malcolm): "This argument is going in circles. Reducing costs to consumers raises consumption. Subsidized goods are overconsumed. In Hawaii, a State agency pays the tab for medical services to welfare recipients. The hospital collects from conscious walk-in patients information that they need, to determine whom to bill. People whose care is covered by employers' insurance or insurance which they themselves purchase must usually pay some fraction of the bill. For people who will pay part of the bill, there is a strong incentive to avoid expensive ER care in non-imergency situations. This consideration is lacking in the calculation made by people whose bill is covered 100% by taxpayers."

I answered the questions. More than once. That's why "this argument is going in circles".In the complete absence of any objective, verifiable evidence on your part, it's going nowhere.The forum title is Political, Social, and Economic --Theory--.Your claim about your lemon tree does not contradict facts and so is non-controversial; no one needs to see your lemon tree to know that your claim is not inconsistent with reality.My claims about the effects of subsidization are consistent with observed behavior in other areas. My observation that people commit insurance fraud is entirely consistent with observed facts. Your claim about those whose healthcare is paid by the state, however, and which you erroneously persist in calling "welfare recepients," does contradict facts.I claimed that the State pays the medical bills for welfare recipients, not that everyone whose bill is paid by the State is a welfare recipient.The majority of those covered by medicaid live in households in which at least one person or more is working full-time, often at or close to minimum wage. They are gainfully employed yet still impoverished.And your point is...? In Hawaii, a State agency pays the tab for medical services to welfare recipients.It's administered by the Department of Human Services, and its programs, as in most states, are jointly funded by both the state and the federal government. And as in most states, it covers many people who are employed full time (a.k.a. the "working poor").The hospital collects from conscious walk-in patients information that they need, to determine whom to bill.Correct, but that still doesn't explain how your girlfriend, who you say worked in an ER as a nurse, would have anything to do with that information. ER Nurses don't bill patients and aren't the ones who collect billing information from patients when they come to the hospital.Sorry I didn't think to break out the thumbscrews when she told me about the surge of welfare cases who walk in after 4:30. It didn't occur to me at that time that some time in the remote future someone would doubt that ER staff talk to each other about their workload.People whose care is covered by employers' insurance or insurance which they themselves purchase must usually pay some fraction of the bill. For people who will pay part of the bill, there is a strong incentive to avoid expensive ER care in non-imergency situations. This consideration is lacking in the calculation made by people whose bill is covered 100% by taxpayers.Now you've gone from using the hearsay anecdote from an old girlfriend to conjecture. Both arguments share in common the unfortunate trait of being completely devoid of any objective, verifiable evidence; in other words, they aren't good arguments.People respond to prices. Subsidies lower (apparent) prices. The cost of ER treatment is lower for welfare cases than for people whose insurance requires a copayment.

Don2 (Don1 Revised)

May 22, 2007, 10:34 PM

The cost of ER treatment is lower for welfare cases than for people whose insurance requires a copayment.
Some citizens of Japan have subsidized healthcare and it is working great there. The country is fully covered, meaning everyone has health care insurance in one form or another. It works better than here.

As to your girlfriend's claims about "welfare cases" coming in after 4:30pm, I am not sure how she knew they were on welfare. Can you explain that? And can you explain why she was complaining to you about "welfare cases?" And can you explain exactly how this is relevant to the op?

Metaphor

May 22, 2007, 11:16 PM

Oh, I would accept public health indicators. <snip>
....And I disagree.

Nitrous, I am pressed for time right now and need to look up some facts, but I will respond to your post later.

However, since we disagree at first principles (that wealthy nations have an obligation to provide health care to citizens regardless of ability to pay), I'm not sure there will be any meeting of minds.

Metaphor

May 22, 2007, 11:24 PM

That''s the point; glad to get some agreement. Both ER and the free clinic are "free" to welfare recipients. While the clinic is open, ER staff will tell welfare recipients with non-emergency conditions to go to the free clinic. After the free clinic closes, if they walk into the ER, the ER will treat them. They avoid the lines at the free clinic by waiting until it closes and using Emergency care. People to whom neither standard care nor ER care is free will take into consideration the added cost of the ER.I've reached that conclusion. .

How long you wait at ER depends not on when you get in, but on how the triage has decided the priority of cases. So, going to ER is not going to shorten your wait unless you have a genuine emergency. And if you HAVE a genuine emergency, you should be in ER anyway, not at a 'free clinic'.

I don't know what the price differential is between visiting the ER and visiting a GP, because I live in a country where you don't have to debate with yourself whether the bad stomach feeling you have is bad chicken or the beginnings of death by destroying angel mushrooms.

1. I don't believe I overconsume health care. I do vary in my consumprion depending on whether I have insurance or not.
2. Some people will run to the doctor for wounds that others will just wash with soap and H2O2. Some doctors are happy to run up the bill.
3. There are crooks in this world.

I did not say "people in general would" (overconsume). I said subsidization raises participation at all levels. .

You used the word overconsume many times. Increases in consumption IS NOT CONGRUENT with overconsumption. So I agree that there would be an increase in consumption I do NOT agree that it would lead to systemic overconsumption of any kind.

Dr Rick

May 23, 2007, 12:23 AM

The forum title is Political, Social, and Economic --Theory--.Theory is not the same as make-believe.

Canard DuJour

May 23, 2007, 04:16 AM

Not false, Canada's health care expense and drug expenditure would come now where near providing enough if we had to rely on it.Eh?!

What's false (http://www.bmj.com/cgi/content/full/331/7522/958) is that "most countries get subsized from the US but get the credit."

No one is claiming that Canada's expenditure alone would provide for everyone else. As you well know.

Easy scenerio.....Let's not allow cross-border information flow and then really compare health care systems.Obvious outcome...Everyone would suffer from the smaller knowledge pool - including the US where pharmaceutical companies invest proportionately less of their revenues from domestic sales in research and development than do companies in the UK.

Canard DuJour

May 23, 2007, 04:24 AM

(malcolm):
1. I don't believe I overconsume health care. I do vary in my consumprion depending on whether I have insurance or not.
2. Some people will run to the doctor for wounds that others will just wash with soap and H2O2. Some doctors are happy to run up the bill.
3. There are crooks in this world.1. I don't believe I do either and am insured by virtue of citizenship.
2. Not if they get a salary from a nationalised system. They're more likely to point to the door while politely asking you not to waste their valuable time again.
3. Many of whom are in the insurance racket.

I did not say "people in general would" (overconsume). I said subsidization raises participation at all levels.Then don't subsidise it. Implement a universal insurance scheme instead.

Increased consumption =/= overconsumption. Ask people who've been bankrupted by medical bills.