Before you begin reading, please take note that this will be a lengthy essay. I believe that up to this point I have never written anything of such immediate importance to the American people. I owe it to the issue at hand to give it the full length and time necessary to fully articulate what is at stake.
Six months ago, I wrote in "The Three Transgressions" my opinion on how we ourselves have provoked the problems with our Health Care system. Chief among my concerns was addressing the desire for public health care. I deemed it a political diversion, a red herring, something designed to keep our eyes away from the real focus. In some ways, I remain steadfast in this belief. Our reliance on pharmaceutical companies built on the principle of keeping everyone just sick enough is an abomination upon our society. However, on another topic, my view has changed entirely.
We need a system of universal health care. I am going to explain why, and point-by-point address every concern, legitimate or fallacious, which prevents us from a country as caring for all of our citizens, and how we can make this a reality.
1) Universal Coverage and the Natural Monopoly
Politicians who are against social health care or even simply having a public option will tell you that the real way to drive down costs is to deregulate. If we give private health insurers more leeway with how they do business, it will reduce costs for them and let them lower costs for their patients. Lowering costs will lead to competition, further giving insurers cause to make things easier for their customers. That's capitalism at its finest - you introduce competition, and the first thing that will happen is lower prices to attract more people.
The people who tell you this are either deliberately misleading you or actually have no idea how insurance works.
Insurance operates by pooling risk -the more people under one umbrella, the more the risk is spread out.
It is therefore impossible for any private insurer to provide coverage as well as the government can.
I'll explain another way; you are paying for electricity. When you use electricity during the month, the power company bills you for however much you use. If you use less, you pay less. More, and you pay more. What you do with your power does not affect anybody else using the same grid as you. To compare health insurance to this system or others like it is a lie.
There is no business model in the world comparable to insurance. I repeat, there is no business model in the world. You cannot draw comparisons between health insurance and utilities companies, or car sales, or department stores.
The reason is that when you pay for health insurance you are getting nothing. Health insurance companies do not provide a service for you. They bill you each month hoping that you will never in your lifetime call upon them to do anything. And in the event that they do, you still aren't getting a service - hospitals, doctors, drug companies - they provide the service. The insurance company simply pays for it.
But they don't want to pay for it - they want to continue taking your money for nothing. They create any number of scenarios wherein they will not pay. I used to work in car insurance, and had to tell a woman whose car had died, leaving her with no way to get to her job, that there was nothing we could do because she hadn't been in a collision. Health insurance works the same way. Furthermore, in the case of those who cannot become insured due to pre-existing conditions, competition does nothing to help them. Deregulating insurance will do nothing to help those who already cannot obtain it.
So it doesn't matter how little you use your insurance, they will always charge you the same amount for it. Moreover, they have the power to change their rates simply because they want to. Here is the major difference, though, between insurance and any other service you might pay for. When insurance companies do pay out to other people, they recoup the losses by charging everybody else a little bit more. The smaller the pool, the more that ripple is felt.
Therefore, insurance which covers 300 million people is automatically 300 times as cost effective as a private insurer with a million customers.
Therefore, even if you had 2 private companies covering everyone in the country, it would still not be as efficient as the single payer option.
Insurance is a natural monopoly. This means that regardless of how well they work, it is impossible for two competing companies to provide service as well as one without competition. People will try to tell you that this is un-American, that it follows a socialist ideal, and that it will be bad for business and everyone will suffer. These people do not know how insurance works. Either that, or they do and are just lying to you. Either that, or they are simply following an ideological objection rather than a scientific one. There are some people who would rather pay more for the same service because they do not want government in control of health care. This is purely ideological. It is the same thing as arguing religion.
People who object to this theory will point to the fact that several times in history, utility companies have tried to convince the government that they are a natural monopoly. However, statistics prove that deregulation actually drives down costs significantly in the energy field. To those people, I say again, because I really have to drive this point home, insurance does not operate like any other business in the world.
Universal health coverage will only reduce what everybody pays. Do not believe the argument about increased costs. This really is a better deal than what we have.
2) Efficiency of Care
Let me break down the costs of health insurance for you by country.
#1: United States (13.9% of Gross Domestic Product)
#2: Switzerland (10.9%)
#3: Germany (10.8%)
Those numbers indicate that the United States pays more for health insurance than any other country in the world, followed by Switzerland and Germany, respectively. The common trend here is that all 3 of these countries have privatized health coverage.
The spending on average by other countries with social health care is 7.2% of their GDP. These are countries with Gross Domestic Products significantly less than the United States still spending half of what we do percentage-wise.
Now, the claim many make when this point is raised is that they are receiving inferior coverage. Obviously, that is why so many Canadians cross the border into the United States to receive health care. Their long waits and rationed care make it easier for those with private health care to simply cross the border and get access to our fast, efficient coverage.
This claim is completely wrong. In fact, studies on the issue prove that the level of health care the United States provides is significantly less than that given by countries with socialized systems. The reason so many Canadians come over the border? Organ transplants. The overwhelming majority of expenditures by Canadians is on organ donations. Why do they come to the United States for these?
Because the United States's mortality rates amongst the younger population are incredibly higher than Canada's. They can't get the same access because their countrymen are just too healthy.
Furthermore, Switzerland has already put into place the kind of reforms that we are clamoring for here in America, and is still nearly 50% more expensive than the most expensive social system. When more people get coverage, coverage on average improves. There is absolutely no mathematical data to refute this, and more than enough to support it.
To put it in more visible numbers - the United States, which pays more for health insurance than any other country and, along with Canada, makes up nearly half the world's pharmaceutical market, still has the 9th highest cancer mortality rate in the world. Out of every 100,000 people in the United States, 321.9 die of cancer.
There have been studies published which point to the United States having higher survival rates than nearly any other country when it comes to breast, colon, prostate, or rectal cancer. The reality is that we have the highest survival rates because we have more people getting cancer. More people getting cancer means that, especially when using data involving the four most survivable forms of cancer, of course the United States will appear to have fantastic numbers. The truth is that no matter how good the numbers look, we are another world leader when it comes to cancer deaths.
The fact, mathematically provable, is that France has the best health care in the world. They pay more for universal health care than any other country, but still 40% less than what we pay in the United States. They are more cost efficient, more health efficient, and charge people less. There is absolutely no evidence to support the theory that our quality of health care will suffer due to universal coverage. None. There is only conjecture and ideology. Every scrap of data proves that the opposite is true.
3) Health Care Rationing and "Death Panels"
Another common claim is that, with more people insured, we will not have the supply to meet the demand. Thus the only way to provide for everybody will be to ration off health care. This has led to the belief that there will be "Death Panels" - people who get to decide who lives and who dies based on need for coverage.
I'm reasonably certain most educated people have abandoned this idea, but I still feel it needs to be addressed. Death Panels already exist. If you have health insurance, you are already paying for them. Every day, doctors argue with insurance companies to actually shell out the money to pay for their customer's treatments. Every day, insurance company review boards plan out ways in which they can avoid having to pay anything. Your health care is already rationed. This is a problem now. The argument was put best for me in terms of buying a new car.
You decide to buy a new car. You're very excited.
A friend of yours says "Don't do that - you'll have to pay for insurance, maintenance, gas - it'll be horrible!"
You say "Oh wow, thanks! I'll just keep the car I have."
Do you see the problem here? Our current system has all of the same issues as the ones being espoused as reasons not to have universal coverage. People who cling to the theory that we can expect to have our lifespans controlled by the government apparently find it perfectly acceptable to have this done by private companies instead.
Being a doctor means that you are, at least half the time, on the phone with an insurance company asking why your patient isn't getting coverage. If nothing else, instituting a universal, single-payer system means that doctors will have more time to treat patients. The myth that care will have to be rationed out is exactly that - a myth. Your insurers are doing this to you right now and expecting you to look the other way because they know you will support universal health care if you stop to think about it.
Speaking of time with the doctor, another common point is that there are absurdly long waits in emergency rooms for countries with social systems. It's not uncommon to wait 4 or 5 hours, or longer, awaiting attention for even the worst injuries or ailments. Of course, when people make this argument, they ignore that the same thing happens here. Countries with social health care are not unique in this - sometimes there are more people than a hospital can accommodate at once. This has to do with the doctor to patient ratio, not health insurance involved. Although, as stated above, if there wasn't so much time spent arguing with health insurance companies, that would very likely result in at least a marginal overall improvement in the amount of time doctors could be with patients.
At this point, if you're following along, you have to be asking yourself, "well, why would politicians not support something which is so obviously good for the country?"
Easy. There is a Democratic President in office and Republicans want to make sure that doesn't happen again in 2012. They don't care if you have health care or not, they want to take a stand against a system because they know if it is implemented that it will work. When that happens, it all but guarantees a second term for Barack Obama. They will say anything to prevent this from happening. It is no mistake that the legislators against health care are overwhelmingly Republican. This is not a matter of "conservative" versus "liberal." This is purely political, and the American public is going to suffer for it if we let it happen.
"But what about Democrats who don't support universal health care?"
I'm glad you asked. Let's look at the recent Senate Finance Committee vote which shut down the hope of a public option.
All 10 Republicans on the committee voted against having a public option. 5 Democrats also voted against it, bringing the count to 15-8 against. Those 5 Democrats were Max Baucas (MT), Blanch Lincoln (AK), Bill Nelson (FL), Kent Conrad (ND), and Tom Carper (DE).
Notice anything about those Senators? With the exception of Tom Carper, they are all Democratic Senators from states with a majority of Republican voters. I shouldn't have to draw you a map here.
On this I'm digressing from why health care should be socialized, so let's move on to the next point.
4) Paying for Nothing
Proponents of private insurance insist that with our current system, people only pay for the coverage they want. Socializing medicine means that we'll all be paying for everybody. We don't want to pay for everybody, they say. If someone can't get a job to pay for their own insurance, or has a pre-existing condition not covered, then that's their problem. It's hard enough taking care of yourself, you shouldn't have to worry about everybody else.
Ignoring all the proof that social medicine reduces costs for everybody, we could hope people would at least care a little more about looking out for the less fortunate. But even being as greedy as possible, universal health care is still smarter.
The ballpark figure of uninsured in America is 50,000,000 people. This means that if nothing else changes, if instituting universal health care is the only thing that happens and all other current systems remain in place, we can expect a 16.7% increase in our costs. Leaving alone the fact that this is still a 100% increase in the quality of care for 50,000,000 people, let's examine why this is simply incorrect on the whole.
We have already established that as coverage range increases, so does the quality of coverage. The numbers from other nations don't lie. Now, let's think about what happens currently to disprove that 16.7% with some hard examples.
The "250,000,000 already insured" that opponents of the universal system like to throw around ignores a basic fact. As many as 25,000,000 and likely much more of that number are underinsured. This presents the same basic problem as those with no insurance at all. Rising costs have led to people simply not being able to afford even employer-based health coverage. Even though they are listed as insured on surveys, they still do not have the coverage necessary to provide for them when they need it.
What does this mean for you? Well, when hospitals have to provide care for someone who can't pay for it, they often just list it as bad debt. That bad debt does not simply disappear. It gets written off and paid for by charities, the government, or passed on into what the medical industry charges private insurers. The money has to come from somewhere, but in every case it still comes from you. Do not be fooled by the claims of paying for people who can't afford their coverage - you are doing this right now. You might not see it, but every time your health insurance premium rises for no reason, or there's a budget shortfall and your local school doesn't get a big enough grant, you can bet that somewhere in the reason are the uninsured and underinsured of America.
Covering everybody will only make it cheaper. Right now these people avoid the doctor as much as they can because they don't have insurance. Ultimately, they end up in the hospital anyway, with a disease or injury far more progressed than it would be otherwise. This means treatment takes longer, costs more, and may perhaps do less. If that patient dies? Their bill does not disappear. You pay for it. You are paying for it now whether we have social health care or not. If that person did not have to worry about insurance, they may have gone when their illness was still treatable, reducing the costs involved for everybody.
Don't let greed or indifference blind you to the obvious. There is no financial reason not to have universal health care.
As I stated earlier, the only serious objection someone can raise to universal health care is that they do not want the government controlling the industry. This, again, is an ideological problem, not one based in fact. And in this case, the ideology is going to end up being more expensive for the entire country. I am not here posing a moral argument for universal health care or espousing my overwhelming support for our President or his administration. I am presenting the facts, unadulterated, which prove beyond the shadow of a doubt a universal system is superior to a privatized one. Calls of "socialism," "Death panels," ad infinitum, are red herrings meant to distract voters from something proposed for our benefit and for our own good being turned into a purely political issue.
These facts were presented to me in roughly the same form I now give them to you. I entered a debate on the side of keeping health insurance private, but my arguments simply could not stand up to the overwhelming tide of contrary evidence I was assailed with. Once I did the research proving the opposition's claims were true, my prior objections seemed nothing short of plain silly.
So now I turn to you. There has never been a time in the span of my life where health care was more prominent an issue and the reality of universal health coverage closer to us. This is where we must band together as a nation - put aside labels of political affiliation and realize that this really is the right thing to do. Your Senators, your Governors and Congressmen, your elected representatives of all office, they will listen to you if you speak loudly enough. Enough voices acting as one can accomplish anything, and it is high time they began acting to accomplish the right things.
I urge you, call your legislators. Send them letters. If necessary, rally so that they can see your numbers. We see news programs all the time showing footage of people banding together in large groups only to display their own ignorance or petty wants. This is something which is legitimately good for everybody. It is right for all of us. We can take this moment to educate ourselves and fight for something positive for us, our children, and our grandchildren. All we have to do is become active on this one thing and we can ensure a real, lasting, positive change.
Thank you, and God bless.
Sources:
Health Care for all Colorado
What is a Natural Monopoly?
NCHC: Facts About Healthcare - Health Insurance Costs
Why Does U.S. Health Care Cost So Much?
Snapshots: Health Care Spending in the United States and OECD Countries
WHO Statistical Information System
Business Roundtable Health Care Value Comparability Study
Newsweek: We Already Have Health-Care Rationing
"Rationing" Health Care: What Does It Mean?
NCHC - Facts About Healthcare - Health Coverage
CNN Money - "Underinsured" Americans may raise all health care costs
How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007
Why I Answered Ozkirbas's Question The Way I Did
Posts
And so we witness the end.
10 years ago
59 comments:
So that's what you were up typing down the hall till 4am about.
Excellent stuff. I think it is key to get down to the roots of the problem - so often in our national debates we look at symptoms and short-term effects, but if we want any kind of true improvements, we have to consider the underlying truths - in this case, as you pointed out, the specialness of the insurance business in economic terms, which makes it uniquely suited to universal care.
I would like to see sources on some of your references to other nations' statistics - not because I don't believe you, but because it will strengthen your argument, and make it more unassailable and easier to pass around the Internet - or submit to a major newspaper or blog, as I encourage you to consider doing.
Get some sleep!
-Brett
Nicely done. One of the best things we've had on this blog so far.
David,
Wow, absolutely brilliant! You've cut through the bullshit, and you've done it well!
This is such a key issue, not just because we need Universal Health Care, but because we need to free the American people from their unthinking fealty to the two-party argument system.
We are being lied to on a constant basis for petty political gains. Both sides do it, and there are countless factors to take into account when determining individual and collective agendas for it, which makes the whole thing terribly complex. The only thing we can do, as people, is cut through the bullshit and not allow the noise to drown out the facts.
Thanks David, hope this post receives tons of hits.
what?! no pictures?!!
the world needs more open minded republicans like you, david.
You may be a republican but you are a liberal republican... not that there is anything wrong with that... but why don't you call yourself what you are, a "liberal".
As far as your funny and, sadly, misinformed, though very thought out, essay... I defer to the Heritage Foundation to make my argument for me (http://www.heritage.org/research/healthcare/). I recommend you read a little... also I recommend that you take a class in basic economics or in the very least read Basic Economics by Thomas Sowell... you, sir, have no clue.
I also find it funny that liberals such as those found on this blog think that they are smart enough to address issues like this... especially when so many examples of what they propose exist and have all failed miserably. Socialism has failed everywhere it has been tried. Capitalism and conservative principles succeed every time they are tried... but of course liberals like to ignore history...
I pray for the sake of our country that this socialistic nightmare fails...
@ Anonymous -
I have no problem with you disagreeing with the post, or what you feel is the general tenor of our blog. I'd welcome conversation on the issue with someone of a different viewpoint.
But I am disappointed that you chose to post anonymously, and it greatly takes away your credibility and voice.
You are entitled to your opinions - I wish you would own them.
I am deployed overseas and due to the security settings on our networks it will not allow me to log into my google account.
I just realized it would let me put a first name... so i did that for ya.
Thank you Justin, it's very much appreciated. I'm really glad you took the time to read and check out the blog - agree or not, that means a lot.
I hope things are going well for you overseas.
when ya get shot at for a living it puts a lot of this political crap in perspective...
I may have time between flights (I'm a pilot) to refute each point in turn so if I find the time (and if I feel like wasting time debating politics again, haha) I'll get back on here...
If you feel like writing a full article on the other side in response, e-mail it to me at jschlaf@gmail.com and I'll post it as a Guest Gentleman post. Then with both sides represented a better conversation can take place.
@Justin -
I appreciate your comments and your enthusiasm for capitalism.
It blatently ignores the stone cold fact that insurance as an industry is socialist in nature and just does not work as well in a capitalist business model.
There is absolutely no example anywhere in the world to refute this.
For every other industry I can think of, I'm with you all the way. However I can only surmise you either did not read my post thoroughly or are simply ignoring the parts you don't like. I'm not arguing ideology. I'm not arguing conservatism or liberalism. I'm giving you math.
Whether you approve of it or not, insurance is a socialist industry and just does not work as well anywhere if not completely socialized.
Here's the one sentance argument of support I'd say just to echo David: every other country I would want to live in has universal health care, and it is cheaper than here.
I will avoid anything snide toward Justin except simply to say I have no qualms or second thoughts about any of my political positions.
David, thank you for writing this. I have been waiting for you to write something like this for a long time. As dear to my heart as you know this issue is, I want you to know that you have made my day today. This is easily the best piece you've ever written. I have forwarded this piece to everyone I know. Hopefully your common sense is contagious.
"I'm not arguing ideology. I'm not arguing conservatism or liberalism. I'm giving you math.
Whether you approve of it or not, insurance is a socialist industry and just does not work as well anywhere if not completely socialized."
Bravo! And Max is correct. I found this map a while ago and thought it was really interesting... http://www.gadling.com/media/2007/07/healthcareworldbig.jpg
Last year when I lived in Italy I didn't have to worry about getting sick, even though I wasn't Italian, I would be cared for (I was there legally.) Now I return to my own country to finish my education and find myself with no health insurance. Is this really what Americans want to be known for?
My grandmother was diagnosed with ovarian cancer last year. Her prognosis is not good. She and my grandfather were too poor to afford private health insurance: they are small business owners/operators and the cost was just simply too high for them, so they went without. My grandmother walked around with a malignant tumor in her abdomen for SIX months while she waited it out until her 65th birthday, when she could finally see a doctor. On her birthday, she was diagnosed with stage IV ovarian cancer. The doctors have said if she'd had insurance and come in when she first started feeling ill, her prognosis would have been better and she'd probably have been cured. Instead, my grandmother has been fighting for her life, and continues to. Why should she and my grandfather, who have always worked hard, paid taxes and respected the law -- be punished simply because they are poor?
"Mr. Future President? Mr. Future President! Quick Question!"
How would you address the issue concerning whether or not universally instituted healthcare may cause decreases in the average salaries, not just of doctors and specialists, but of pharmacists and nurses, specialized or not?
"Also, one more question, Mr. Future President"
In your opinion, do you think universal healthcare would open more doors for people seeking psychological treatment and therapy, close those doors, or not effect this area at all?
Well thought out and I appreciate your essay. But I'm afraid I still don't agree with you. What I think you fail to consider is that this plan may be well and good in THEORY (so was Socialism, and communism), but it depends much too heavily on two things - the fact that the people in our government are totally benevolent beings, lacking in corruption and the desire for more power whenever available; and that we can fiscally support this system.
I think you'll agree that in the current and past few administrations, corruption and greed for more influence has spread like a cancer, enabling cronyism to become more and more palatable to the complacent American people, partially due to the extremely left media's refusal to report it even when it blatantly happens. I just don't believe that these people won't bastardize the system to line their own pockets and the pockets of their buddies all over the country. They've already done it with SEIU and the Tides Foundation to name a few in this administration, what makes you think they won't use this new health care system for their own purposes and agendas just because it's 'Health Care'?
I get your argument that this business model is different and depends on less competition to succeed, but doing so is a very dangerous and slippery slope. I ask you to think about just what kind of repercussions doing something like handing over our whole health care system, and the dependency that creates, to the government (or anyone for that matter) would actually have? "Power corrupts, Absolute power corrupts absolutely." Handing over our health care to anyone, especially a government that seems to want to spend our money rampantly and exist without limitations, seems to me to be a foolish exercise in idealism because you must truly believe those fatcats in DC have YOUR best interest in mind. But I think you are too smart to really believe that, right?
I know it sounds paranoid, but do you really think that if it came down to it, they wouldn't use our Health Care as a tool, a bargaining chip to force the American public's hand in the event they need to further an agenda that is unpopular? Hopefully not, but unfortunately I wouldn't put that past any administration, Republican or Democrat and the risk universalizing health care puts us in is not worth the gains.
Continued...
(Continuation from above due to my inability to edit my words!)
And for that matter, can anyone really tell me why all of a sudden this is a crisis? Weren't we in a housing crash? Aren't our banks failing? Why is it that the government is focusing on something that wasn't nearly as broken as the rest of our economy? TARP was a bandaid, the Stimulus Package was a bandaid that failed, and Cash for clunkers just failed. Instead of arguing about Health Care, how about they try to get our economy back on track? And printing more money is just setting us up for hyperinflation.
Speaking of money too - We. Can't. Afford. It. Period. Our country is so far in debt right now that implementing these new plans would further bankrupt our treasury. And please don't tell me you think Obama was realistic when he claimed it wouldn't add a dime to the national debt. Bull, sweetly delivered amoung flowery words during the Prez's address on health care, but pure and utter Bull nonetheless.
Ask someone like my Dad who is a Vietnam vet how his VA health care is panning out and you'll find out just haw capable our government is at running a health care system.
Lastly, I'll say that SOME deregulation and opening up insurance to a free market system would certainly resolve much of this issue. Plus, Tort reform, which the Dems refuse to talk about (probably because most of them are all lawyers, lobbyists, or the like themselves) would reduce current medical costs vastly. My Husband's father has to pay over $200K a year just to cover his ass in case of a frivolous lawsuit. That cost, to some extent, is transferred directly to his patients. If we could regulate the system's tolerance for these stupid lawsuits, we could eliminate a lot of cost on both sides.
I guess I got a tad long-winded and you have my apologies for that. Thanks for listening and keeping the dialogue open and fair!
I'm not going to pretend to know nearly as much about this as other people do, because I don't. So my comment/question is based conceptually rather than data based -
but like i said back in the Health Care roundtable, wouldn't having both competent private and government health care options be best? the people who could afford to pay more would, like in education or other industries, understanding they will owe more. And then everoyne else is at least covered.
This system has obvious flwas, i know, and is not perfect. Though I don't think any system will be. like most arguments, I think the answer probably lies in a compromise.
And yes, I mean most arguments in all of life.
@Mailel -
Excellent comments! I'm sorry I cannot respond to them right away. I will be back with you as soon as possible.
Car insurance is privatized. Should it be taken over by the government to lower costs as well?
I appreciate this post. I would have liked some of your sources for numbers. Not because I disagree with you, just plain curiosity. The (meager) research that I have done into the topic has come to same result. Universal Health care is a more efficient system in every way.
There are two reasons I don't support creating a universal health care system:
1. The initial costs. Yes, universal health care is more efficient. It would take us decades until we've found a system that works for us, and fully implement it. Knowing our government, we would probably fuck it up. It would pay for itself, sure, in 50 years. I'm just worried about our current level of debt. We pull out of Afghanistan, drop the climate regulation legislation that is being debated, and I could see myself being more open to universal health care.
2. I'm paranoid. I just don't like the idea of the body that controls the armed forces, and has increased control of the business sector, having complete control over my access to health care.
People always list Europe as this Utopian society with amazing health care. They forget the oppressive taxes, oppressed civil liberties and crippling debt Europe is in (Yes, they have it even worse than us, based on GDP).
While some members of this blog have said they wouldn't mind paying 40% of their income if everyone got health care, I think the majority of Americans would rather not. Especially considering the majority of Americans are happy with their health insurance.
I'm not as adamantly against universal health care as I was before I did some research on it, but I still do not desire it for the U.S.
Not that any of this discussion matters. If our legislative branch doesn't have a perfect plan by the end of the year they'll just bully whatever they have through. It'll be a bastardized mix of public and private health and won't be as efficient as a pure system of either.
http://www.cbcn.ca/documents/pdf/ENG_CBCN_fin_book.pdf
Interesting look at breast cancer treatment in Canada... why does it take them 7 weeks to diagnose after a biopsy? I'm pretty sure it is faster in the states... like maybe by next week? Median time from abnormal screen to diagnosis appears to be somewhere around 4 weeks... healthcare providers recommend treatment to begin in 2 weeks... in Canada you won't even be diagnosed in time to supposedly start treatment which in Quebec takes another 4 weeks... so you don't even start radiation on your cancer for approximately 8 weeks... in the states... well you get the picture.
more interesting info on Canada:
http://www.theglobeandmail.com/archives/vow-broken-on-cancer-wait-times/article857684/
@Dennis
I wish I only paid 40% of my income to taxes...
I like that map of countries with and without universal healthcare. All my favorites are grey!
"do you really think that if it came down to it, they wouldn't use our Health Care as a tool, a bargaining chip to force the American public's hand in the event they need to further an agenda that is unpopular?"
Exactly Mailei. Giving a single body that much power is just asking for it to be abused. I do not believe that any government is benevolent, the same way I don't believe any corporation is benevolent. Neither one of them should have too much power, even if that means the system(s) are less efficient.
After working in the hospital, I can gladly tell you universal health care is not the right option for health care reform in the US. The majority of the costs are not from the care itself but the underlying cause that US people are unhealthy and noncompliant with the education they receive to prevent a lot of the top-killing, preventable diseases in the country. In fact, hospitals are trying to cut costs--but the only way they can is by compromising patient care and having nurses and doctors not follow most protocol step-by-step (but not really doing anything illegal). This really just increases costs--they may save equipment, but they are risking nosocomial infections, which are costs the hospital must pay for (and thus passed onto the consumer). If you want examples, I can tell you like 10 in 2 days that the RN's fucked up and will probably get hit with a nosocomial infection just in one floor of the hospital.
And btw, Switzerland is combination market. Everyone (legal) has a very basic plan from their canton, and then most people buy private insurance so they can get good care on top of that. They also have the fastest, most autonomous, and most technology in Europe when it comes to health care.
You get what you pay for, both in terms of service.. and if you're unhealthy, well...
Part 1:
You're efficiency argument is a little off base. If there's a value in universal health care, its by requiring younger and healthier people to buy health insurance and thus getting premiums from people who wouldn't otherwise buy insurance. That puts more into the pot, so to speak, so premiums for the other customers will be reduced. Health insurance premiums are not especially responsive to diversification through increasing a customer base. Its sort of like claiming your diversfying in the stock market by holding long positions in all the major automakers, their suppliers, and creditors. Youre not diversifying at all -you just have policies for alot of sick people. So its not that "the more people..the more the risk is spead out" -- its the more diverse the consumer base, the more the risk is spread out. Thats not a fine point. It puts alot of doubt on both the "300 times more efficient" comment and the "2 private companies point" (which i wouldn't pick on but they're bolded, so they must be important.) The value of this diversification is negligible past a certain point, and its well below even where we are now.
Second, and this also isn't a fine point - what we're talking about here is competing on premiums, but premiums arn't strictly a result of who you insure. Insurance companies hire slews of actuaries to handle risk management, which is really the way these firms compete. Each company tries to estimate the "failure rate" of their customers in a way that lets them predict their cash flows as accurately as possible. Insurance companies want to charge enough to keep premiums flowing in at a rate that will cover their operational costs, but still remain competitive. If I knew how to bold this I would - health insurance companies compete through risk management practice, and its this skill intensive competition that keeps rates down. This keeps the total premium charges right in line with the costs of the care.
The fundamental difference, I expect, is that rather than charging people on how much they need the product and their risk factors, universal health care would have us ending up charging by ability to pay. I'm not going to argue about which is better- I don't think its obvious either way- but what's more concerning is that we're losing the market force that keeps rates right about at the risk you pose to these firms. Once we filter this through the tax system, there's alot more ambiguity. Without the concern of staying competitve, there's nothing to say that the tax revenue collected wont exceede the total costs of care rendered.
Part 2
" In fact, studies on the issue prove that the level of health care the United States provides is significantly less than that given by countries with socialized systems." The US actually fares well when it comes to healthcare screening (which I've heard is part of the reason it looks like more people are dying from certain diseases than in other countries). Also, many of those studies struggle to get around the fact that we simply don't live healthy lives in the US, and that gives the appearance of a less effictive health care system (See Shao, supra). There's alot of data in both directions, your accusations of lying and misrepresenations dont make that very clear. Heres one for example: http://papers.nber.org/papers/w15213.
I'll conceede that alot of the people against universal healthcare probably know much less about this than you do, and all this talk of socialism isn't helping anyone. I don't know the right answer. This is a complicated issue, and your post could be a little more clear that there's no obvious answer.
For that matter, Germany is also a combined market. Everyone has a basic plan and then can opt for more. And they do. It's a choice for them to pay that amt, or they could just accept the cheaper basic plan. So for Switzerland and Germany, they could just live with their basic plans make health care look cheaper on paper, but they chose to pay for extra private insurance.
If you disagree and think it's a bad idea, then you would actually be supporting a single-payer system specifically rather than universal health care (doesn't need to be a single-payer system).
In Germany it's not that you opt for more, it's that you opt out entirely, which is fairly common due to the same thing in the U.S. the "perception" that private is better.
Single payer is a better option in the sense that it is the cheapest option per capita, well still resulting in a high base-line of care.
With the exception of the UK and some other minor countries, being on the public plan doesn't preclude you from paying more out of pocket for faster/better service.
As a fiscal conservative I'd prefer single payer, but any universal system is better than what we currently have.
Even the "public option" would be great, that's essentially what France has.
@David
Great post. How do you reconcile your previous beliefs? Has this had an effect on any other core political issues you have opinions on? Are you going rogue?
@Justin
What kind of plan do you support? Are you gonna go all Ayn Rand on us? Hands off the insurance companies, is it? What should be done about health care inefficiencies and life ending insurance issues that the free market hasn't addressed? Doesn't this crisis causing bankruptcy and death take a toll on the "human capital" that Thomas Sowell so adamantly triumphs?
Here are some of my thoughts, ignoring the numbers.
As usual: ali d, sorry for my grammar and punctuation.
If Microsoft, BGE and At&T were forced to disband (by the government) because they were too much of a monopoly, I don't see how having one insurance company would be any different. I do understand that insurance is like no other business and, yes theoretically, with with one insurance company it COULD be cheaper. However, you have to believe that the single controlling insurance company only has you and your family's best interests at heart. You also have to believe that once the now only insurance company has control they won't just raise your rates because they can, lower your benefits because they can or leave you standing out in the rain because they couldn't care less, and there would be nothing you could do about it.
Universal health care is like socialism, because it only has a chance to work if those in charge are "benevolent beings lacking in corruption". No matter what side you are on (conservative or liberal) I think we all know there aren't enough benevolent leaders lacking in corruption in the government.
I would further more assert that it is good having multiple private health insurers competing for our patronage as to keep any one company from completely screwing us. As the system stands now (like it or hate it) if you don't like your insurance provider you can find another. Having the companies competing keeps them from getting not just too greedy but also too stingy with your benefits. Yes, insurance companies do not want to pay for your medical needs, but only a fool will believe the government will be any more happy to hand over your hard earned money that they took for just such an occasion. With one government run health care system we will never have the chance to choose again. Once they have that control over us they will not want to give it back, no matter how bad our care gets.
If one private insurer was to by up all the others, (and we were to have one private insurer) and they started giving us poor care the government could step in and disband them or force them to correct their practices. How well do you think that will go when the government is the sole provider of your health care? The answer, at the very least, not well. They will have no competition to keep them striving to give the best care they can and no one above them to keep them honest.
Continued.
You cannot tell me that "We have to have universal health care for people that can't afford insurance". No matter who you are in this once Greater still Great country, you can walk, crawl or be rolled into a hospital and it is illegal to deny you medical treatment. I am not naive enough to believe it doesn't happen, but it is still illegal.
The government should not have control of our health care, that is not what they are here for. If the government takes over there is one less reason for us as individuals to strive to better ourselves and our position, to think for ourselves and to be the best people we can be. The government is trying to tell us we aren't smart enough to handle our own health care and and giving us a way out of trying, and being the apathetic people that some of us are we jump up and down at the chance to have to not work as hard and get something for nothing. I tell you this is a bigger problem than the health care issue and we have one because of the other. I feel bad for the lady in your story who only had collision coverage, I truly do. However, It helps illustrate my point. She should have known she was not covered for anything but collision and should not have even bothered. When I had my first truck, a used '86 Dodge Ram Charger, being young I only wanted insurance to cover the damage I did to someone else. Because I bought my truck out right and that was all I needed or wanted to pay for. And when my truck broke down I didn't call the insurance company expecting them to fix it, I knew what I was covered for and I paid to fix it myself. I am not saying you have to know your policies inside and out, but before you sign anything you should sit down with you agent and find out what you are getting and not getting. Take the time do the WORK. I know that is an unpopular sentiment, but I don't care. Get off your ass, America. For now this is still the country where you can be whatever you want if you work hard for it.
This has taken kind of a turn from what we were talking about. Back to the point. We are not a stupid people, we CAN handle our health care by ourselves. If we take the time and effort to know what we are getting into.
Socialized health care MAY cost the nation less but it will cost hard working individuals more. The more you make the more you will pay. Again people who succeed are being punished for it. Socialized health care is only better for those that can't afford health care, and the rest of us will pay for it. I AM NOT against people who can't afford health care getting it. There is already a system for them and maybe the government should try and fix that system before starting a radical new one. If they can't take care of the few what makes you think they can take care of the many?
@ Justin
Nice.
I'm back, and would like to thank everybody for their comments. It's very important we keep a dialouge going on this issue. I will respond to questions/comments/concerns in the reverse order from which they were received.
@Stephen: My number one stance, first and foremost, is that a figure in power should have the courage to change their stance when proven wrong.
@Dr. Grey: This is more directed at everybody else - Dr. Grey here is the person who educated me on health care. Most of what I put up regarding the economics of the situation is based on his research, and I'm very honored he chose to respond here.
@Aynonymous: It sounds like six in one hand, half a dozen in the other. Though you do make a fine argument regarding the emphasis on some of my points, the basic premise will hold up under scrutiny if not the exact numbers. The more people are enrolled in the same system, the cheaper it becomes for everybody.
Your critique is spot on - there are some facts that can be skewed to make the situation look worse than it really is. Even taking this into account, however, the point still stands that a single-payer system emerges as the most affordable option for everybody without sacrificing level of care.
You are correct in that the answer for solving all the existing problems is not so cut-and-dry, but a single-payer system is the right place to start. Those other concerns I'll tackle in my responses to Mailei and Dennis.
@Shao: At no point do you disprove or even successfully argue the idea that universal health care will be more cost effective. Is it a good idea to further educate our public and medical workers on proper procedures and care? Of course it is. But it has -nothing- to do with the argument at hand. There are plenty of things we can do to lower costs, none of them have anything to do with insurance.
You might as well argue that we don't need universal health care because doctors have to drive to work, so clearly if we had free public transportation costs would go down. I'm not disagreeing with your point, but it doesn't do anything to disprove mine.
@Dennis and Mailei (and now Capt): First, I'll address Dennis's question regarding car insurance. The government already does mandate car insurance - if you live anywhere except New Hampshire (for whatever reason) you must have insurance to drive a car. They also set the minimum liability coverage. I honestly don't have an answer for you about whether or not it would work the same, except to say not everybody drives. Everybody lives.
What I can say regarding privatized insurance is this. Everyone keeps arguing that competition makes prices go down, but with insurance that just isn't the case. Even if you jump from one insurer to another because they give you a better deal, that insurer then raises your premium regularly. They might do this because you're getting older, or because there were a lot of claims in your area, or maybe just because they want to. So their premium gets too high, prompting you to switch insurers. Their premiums are lower, but still more than what you were paying with the first company. So you keep playing ping-pong, saving less and less money each time.
Now, on another note, I agree with you. I do not think that such power should be given to the government. I'm nervous about it, I don't trust it, and I'm certain they'll use it to promote their own agendas. Furthermore, in the back of my head I picture pharmaceutical giants frothing at the mouth to get everyone buying their products and the government footing the bill. It's a scary and uncertain scenario. However, one thing I am firmly convinced on is that we can provide health care for everyone in America, and we can do so while lowering costs. If we don't trust the government we have, we'll have to elect a better one.
@Oz: As I'm answering these questions backwards, I'll take your second one first.
I don't know.
As for the first question, I'm guessing the assumption is that cheaper health care means less money for hospitals. I'm not sure why it would result in private practice doctors charging less, so I'll just address that concern. While the average cost might go down, the number of people seeking care would likely rise. Can I say with certainty these two would balance out? No. But it will temper whatever losses could be expected.
Which brings me to another point I would like to contend. I've seen many places that people shout about the increased taxes to pay for universal health care. Yes. This is definitely true. If the government took over health care we could absolutely expect our taxes to rise in order to cover the costs.
So let's say you receive private insurance through your employer, and in order to cover the premium you lose $75 out of every paycheck. Now you're paying for government health care, and in order to cover it they raise your taxes by $50, also taken out of every paycheck. However, now you're no longer paying for the private health care. You just started saving $25.
Finally, @Justin, I will attach a bibliography with my sources, since you and others did ask for them.
The sources I used for the information have been added to the bottom of the post.
Oh, I realized the WHO link doesn't go directly to the chart I created. I just clicked Canada and the United States and then had it create the table, that should give you the numbers I drew from.
@ David - Kudos on the sources. Totally understand your hesitance to answer my second question. Only reasons why I asked was because you seem knowledgeable and I haven't heard anyone else address that issue (albeit, it's not exactly a heavy hitting one).
Furthering on the second one - potential increase in clientele for hospitals also means, generally, more work for each doctor/nurse/staff member to perform, meaning (for the purposes of this question we'll assume that this doesn't equate to higher chances of negligent medical care) that more could generally go wrong in a given day, giving rise to more frivolous lawsuits (a point you addressed in your original piece, The Three Transgressions). Is this still a concern for you or are we to view these as separate issues entirely? Or, if you'd rather, is my concern here completely off base?
44,000 people die per year due to lack of health insurance, according to this American Journal of Public Health
http://pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf
I don't think I saw that in the post. I think it's an interesting link to add to the ongoing convo, just so we all know what's at stake.
@steve - but those people are dying so we keep our freedom, unlike those commies in sweden and japan and canada and australia, all of whom are very very communist and hate freedom.
How many people die a year with good health insurance? I, again, am not saying people shouldn't have health insurance but people will die with or with out it. How many of those people would have died anyway?
@Capt
Zero would have died anyway. If everyone in the United States had health insurance, all other things constant, 44,000 more people would be saved each year.
@David
But would all things remain constant? There's a legitimate doubt about the effects that a single payer plan would have on the economy. How would single payer start? Are you closing down all of the insurance companies?
In a perfect world, doctors send the government the bill, and the government sends the doctor a check. Transaction complete. Everyone saves money.
But the elimination of spending by hundreds of thousands of american citizens (some portion of the 400,000 in the insurance industry) may, possibly, cause businesses and individuals to go bankrupt. In that case, after an ensuing ripple effect, you've started an era of poverty and desperation. You've started a depression. Would more than 44,000 people die in a depression? Suicide rates could go up by about 3 per 100,000. That's an extra 9000 americans dead just from suicide. People certainly wouldn't die from starvation, but malnutrition and hunger would weaken immune systems, and even more would die.
On the other hand, single payer does have a chance of working. Congratulations, you successfully transitioned an entire industry efficiently and fairly into a government entity. Profits cut out of health insurance companies are turned into discretionary spending for businesses and individuals, who spend money at other business, making others profit in the process. The economy not only recovers, but thrives. A wealthy american public is happy and healthy, making single payer costs decrease. Most importantly, lives are saved.
My point is that single payer seems to me like a huge gamble with one of the only profitable industries left in our economy. A less intrusive program with a lower risk of negatively impacting the economy would be desirable. I think we can agree that while economic downfall would be a greater evil, standing pat won't do anything for the 44k.
Bravo! Excellent stuff! I couldn't agree moar! I would just like to add that, while we're at it, the Federal Government should also supply everyone (especially illegal immigrants) with housing, food, and clothing, all free of cost. Everyone shall work at their assigned task and the government shall provide everything for you in exchange. Everyone will receive an equal share. This is just the first step!
Wow, Anonymous, way to completely miss the point. The argument was not that the government should socialize healthcare, providing it as a free service. It was that the healthcare industry would run more efficiently and benefit more people if it were run and provided to everyone by a single entity. That entity doesn't even necessarily have to be the government in order for David's vision of healthcare to be achieved.
Now, you don't have to agree with this argument. In fact, as evidenced by the many comments preceding yours, we Gentlemen encourage people to challenge our ideas so that they can be debated in a respectful and controlled forum. I personally (other Gentlemen are free to disagree) don't think your fear-mongering propaganda has a place in our discussion, especially as you didn't give us the courtesy of validating your opinions by providing us with a name.
@ Ali - Maybe it's just me, but my only objection to the character of Anonymous's argument is that he posted anonymously. I think your first paragraph addresses his comment finely enough.
@ Most Recent Anonymous - You wanna come back and put a name to that comment? Internet security blanket, much?
@Anonymous
I still don't know where I stand on this issue. I think it's silly to talk health care reform without also talking about pollution in our water, air, and soil, and the lack of nutrition in the food sold to us at 95% of the retail food outlet in the country. The sedentary lives we're living in small offices and high stress. It's not about health care, it's about HEALTH.
That being said, your comment needs refinement (and a purpose beyond spitting venom).
Two things I'd like to point out about your contribution:
1.) We're already paying for the people who don't have health insurance, and it costs far more when they get to the emergency room than if they had preventative care. As far as I can tell -- IF DONE RIGHT -- Universal health care could be economical AND give us all a warm, fuzzy feeling inside. The important question is, can we trust the government to do it right... I dunno.
2.) If you think our lives aren't already as Orwellian as your snide remark implies re: universal health care, they've officially won. Fight this thing as hard as you can, otherwise you won't be free like you are now! :-p
I refuse to believe that the poor must die so that others may enjoy some modicum of comfort and financial success. This is not freedom, this is distraction. The rich prosper and the middle class fights amongst themselves for smaller and smaller scraps of a shrinking pie, to the exclusion of the poor.
America, FUCK YEAH!
We're better than that. Capitalism could be better than that. ANY system COULD be better than that. In the end it's not about how the economy functions, it's about the morals, values, and mutual goals shared by us as a society that (hopefully) aren't deluded and deranged by fear-mongering and quarterly profit imperatives.
We all can and should "profit" from our ideas and our hard work, but what ever happened to love thy neighbor? We have the resources on this planet to allow everyone to live relatively comfortably, but we'd rather use those resources grossly inefficiently and just blame others for not working hard enough against a stacked deck to hoard their won share.
We've definitely lost our way, folks.
Why is everyone so adamant that anonymous posters reveal their name? Would "bob" really enlighten you as to their identity? Even if you could ID them, would that change the statement or its meaning?
Besides if you're really not into it, go into settings and disable anonymous commenting, I seem to remember blogger having that option.
We don't turn off anonymous posting because the only way to do so is to limit comments to only people with blogspot , which we don't want to do. People can still leave their name now, which they should.
Standing by your words is one of the primary principals behind this blog. We may use nicknames, but never aliases or user names. The anonymity of the internet allows people to 'hit and run' and not have to back uppotentially hurtful statements. While this has yet to happen here, we also won't let it get to that level.
Ownership an EXTREMELY important part of this forum, and yes, anonymity robs the idea of it's value in my eyes and the eyes of most of our writers and readers.
"@steve - but those people are dying so we keep our freedom, unlike those commies in sweden and japan and canada and australia, all of whom are very very communist and hate freedom."
A sarcastic comment that implies that people who don't support universal health care are ignorant.
"Bravo! Excellent stuff! I couldn't agree moar! I would just like to add that, while we're at it, the Federal Government should also supply everyone (especially illegal immigrants) with housing, food, and clothing, all free of cost. Everyone shall work at their assigned task and the government shall provide everything for you in exchange. Everyone will receive an equal share. This is just the first step!"
A sarcastic comment that implies that people who support universal health care are communists.
I don't have a problem with either comment. No idea why people are upset about Mr. Anonymous's comment though. "Spitting venom" is fine as long as we put a name on it?
Fine? No, It's probably a little stupid in all cases.
But at least with a name that person is owning up to how they say things. They are standing by it. And yes, that's REALLY important. To me, almost as much as the content in some cases.
Cowardly behavior, whether online or in real life, is not something I respect.
I actually had nothing to say on the anonymity thing. Hence, my comment didn't mention anonymity. My comment had to do with substance, of comments and the basis of the argument itself.
So leave me out of this Jstone!
I'll clarify my objection: I didn't feel that the comment Anonymous posted actually responded to anything that David said, and was instead an overarching knee-jerk reaction to this vague idea of what Universal Healthcare is and could mean. He essentially (in my mind) ran in, screamed SOCIALISTS!, and then ran back out, which I don't find either constructive or valuable in our discussion.
The anonymity bit was really just an add-on because I know it's something that we're trying to promote as a blog. It wasn't anywhere close to being the forefront of my point, and only further negated a comment that, to me, doesn't even apply.
Also, it was 7 a.m. when I read it, and early in the morning things typically seem more egregious to me, and I'm more of a sass-pot.
@Jason- What about all the great and poignant quotes throughout history that are attributed to "unknown" or "anonymous?" Are they less poignant because you can't attach a name? To me refuting someone's argument because they don't "reveal themselves" is not indicative of their cowardice but rather of one's own inability to counter them on the merits of the argument. Besides, this is the internet, anonymity is the beauty of it. No matter how much we all (as members of this community) claim that we won't spit in the eye of nay sayers, it is a legitimate fear that we will. While the types of users that get the most attention for their anonymity are generally flamers, there is a positive aspect to being anonymous espeically with regards to one's safety and self-esteem. We are all anonymous anyway, hell I'm potentially anonymous right now. No one knows who is typing these words, but we all assume they are who they claim they are.
@Damien if that is your real name...- You are a traitor and a member of the rebel alliance! Take him away!
@ Ali- Sass-pot...*giggle*
I don't believe anonymity is the 'beauty' of the internet at all, but more often than not a significant problem with it, and a potential downfall - especially within the context of a message board.
If someone is afraid of response, then they shouldn't post here. We're all putting ourselves at risk to that, whether as a writer or in the comments section. That is one of the sacrifices of public discourse, and no gun is being pointed forcing people to respond in public. I've been privately e-mailed many times in response to TG posts.
An anonymous, apocryphal quote from history is very different than a hit and run comment on the internet. I don't have interest in that. Your mileage may vary, and that's fine, but this is the way I choose to embrace my corner with the values I respect as a Gentleman. And as far as I see it, a Gentleman stands by his words, pretty or not.
So this is my long awaited first post on this blog, and it won't be quite up to snuff, but here goes.
I have a very personal interest in this debate as I just finished beating cancer, so this has certainly pushed me to the side of universal healthcare, however it may be achieved. I was lucky in that I had health insurance and numerous doctors in the family who all pulled whatever strings they could to get me to see one of the best oncologists at MGH, but throughout the whole experience I constantly wondered how I would have fought this if it had occurred when I was not covered by insurance, and did not have the connections that I did. The best I can tell is that I would have been either in debt up to my eyeballs for the rest of my life, or I would have had to declare bankruptcy, seeing as the treatment that I needed cost significantly more than my college education.
My first and foremost concern while dealing with my illness, telling as this is, was not for my health or how my family would handle it, but rather how would I pay for it and handle dealing with the health insurance companies. As much as they may try and claim that they are going to be there when you need them, they will obviously try as hard as possible to get out of paying a dime for anything. I ended up spending a large portion of my time just trying to find out who I was supposed to speak with, let alone what paperwork I was supposed to get to what person and how it should be filled out, all while barely able to get up the stairs to my room or stay awake for more than a few hours at a time. I know, lets all have a pity party for me. My point, that has barely been touched on so far it seems, is that how can we justify the way we treat the ill in this country? We like to claim that we hold ourselves to standards of morality, yet as Steve just pointed out, one of our most profitable industries is the insurance industry. This is an industry whose sole purpose is to profit off of people at the height of their suffering, when they are afforded no other option. Should we really be defending the insurance industry as the potential victims here, or is this a crisis of their own making?
@Oz: Illegitimate lawsuits against our medical staff are always a concern for me. I don't know if it is possible to accurately predict how they will rise or fall with universal care. There will always be people who want to try and take advantage of the system, blind to the harm it does society.
@Steve: That's a very good question. Let's say the government does take over health insurance for everybody. There is an ideal way to institute this system which would not affect so great a portion of people employed by insurance companies. Let me detail here what I would do were I in charge.
(hint hint)
First, the government plan is put into place. Obviously, employees will be needed to run this system, so the prime hiring pool will be current health care workers. Everyone from office staff to management, claims adjusters to legal teams, they'll all have a place in the government team. Let's assume for the sake of argument that we're able to cover the entire country with half the current staff, so 200,000 of those 400,000 will be able to find immediate re-employment with a government job.
The second point I would make is that part of what this plan seeks to achieve is putting money back in the hands of the American people. That means more than just private citizens, it also means corporations large and small which had been paying for health care and now won't have to. With more money in their pockets, they can afford to hire more employees. Will it equal the 200,000 who will still (in this estimation) be out of work? I can't say for certain, of course, but it does mean that the crunch won't be nearly as drastic as you put forth in your first scenario.
@anonymous:
B, you're a jerk.
"what's with all you americans singing 'america fuck yea', i know you love your country, but..." (Damo.... German Laura said that. lol)
ali didn't say anything out of line. i only feel the need to speak up because i am the expert on sass.
~Mia, who owns 'sass'
I swear I've explained Team America: World Police to Laura before. Come on, meow!
Good to hear you're healthy Dandy. You bring up good points about the complexity of the current system. I have been lucky enough to have never needed medical help other than the occasional ear infection when I was a child. I have not dealt with the complexities of a privatized (or public) health care system. When I discuss the health care issue, I'm doing it strictly from a theoretical standpoint, as I have no real personal encounters with it. The complexity of the system would almost certainly go down if a single-payer government run plan was launched.
"The second point I would make is that part of what this plan seeks to achieve is putting money back in the hands of the American people. That means more than just private citizens, it also means corporations large and small which had been paying for health care and now won't have to. With more money in their pockets, they can afford to hire more employees. Will it equal the 200,000 who will still (in this estimation) be out of work? I can't say for certain, of course, but it does mean that the crunch won't be nearly as drastic as you put forth in your first scenario."
@David
I'm not as convinced as you that it would be such a huge break for people and businesses financially. Yes, the cost per person would be cheaper. The federal government would still be picking up the bill for 50 million more people than are currently covered. Our lifestyles are still far more unhealthy than the people of other nations who use socialized medicine. Considering that 47% of the population paid no federal tax this year, where does the money come from to pay for our 275 million people? Of course, it will be taxes.
These taxes, based on the math I've seen, would *likely* cost less than paying for private insurers. Well, at least for us, I'm sure corporations and the rich will be taxed into obscurity.
People act as if under a government plan there would be none of the corruption that we currently see among insurance execs. I don't see how there can be less corruption when one entity will have power over the health care of the entire nation.
Another concern that I have about universal health care, and I'm aware that most of you will consider this to be a paranoid conservative thing, is the mentality it could create.
While anonymous's comment was sarcastic and surely meant to troll, his comment kind of ties into my point. Health care "saves lives" and by saving lives we mean extending lives. You know what else extends lives? Avoiding red meat. Not smoking. Not drinking. Avoiding snack foods. When every citizen is paying taxes for everyone else, how long is it going to take for people to go, "Wait a minute, my taxes are higher because this guy ordered a rare steak!" We already have federal/local governments over-taxing/regulating alcohol, tobacco, sodas, and snack foods. At the rate we are going, smoking will be illegal in the next 25 years. I mean, clove cigarettes are illegal for fucks sake. If we are already experiencing these kinds of restrictions in a mostly private health care system how far will it go under a universal system?
@Dennis
One thing I would have to say about the fear that the government would regulate your unhealthy behaviors is that this is already happening at the hands of both of the insurance companies and the government. If you smoke, are overweight, or have many other risk factors, you probably have to pay a higher premium, or have seen your benefits cut whether they have been clear about it or not. It seems to me that a simpler way to deal with this, rather than making unhealthy practices illegal, is to tax things like cigarettes and alcohol even more than they do, so that it is those who decide to take those risks that end up paying for a larger piece of the healthcare pie. As long as they don't tax pie.
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