Tim, the Enchanter

While living in England I saw first hand many of the problems that you mentioned. In addition, one of the biggest problems with the healthcare system there was the that it fostered dependence on the government. For example, I had a friend there who was a doctor and he was constantly frustrated by people coming to him to fix their teeth because the government healthcare system didn't cover dentists. Although he told them to see a dentist many of them didn't because they would have to pay for it themselves even though they could afford it just fine. It was amazing how many people didn't take care of themselves because they were so used to the government doing it for them.

Furthermore, so many people abused the system. After all, it's free, right? Is there any doubt that the same thing would happen here?
 

I agree that a government controlled system is not what we want, but it seems it is already that way for the most part without government protection of doctors. I don't have any statistics, but it feels like a good portion of our medical expenses go to pay for insurance for doctors because they are constantly being sued for exorbitant amounts of money. Along those same lines I think doctors over prescribe at times for fear of being sued because they didn't do "everything in their power". I'm not sure exactly what a good solution would be, but I do think there are ways to reduce the cost of healthcare so it is more affordable.
 

From outside the US, your system seems to be a failure in so many ways and your reasons for being against universal health care seem to be a paranoid fear of the "Government" and some weird ideas about "Freedom".

From an outcome point of view, the US has the lowest life expectancy compared to Canada, UK and Australia (http://bit.ly/1t6Nm2) but you spend the most (http://bit.ly/W3XUZ) per capita.

As an Australian, I choose the GP I visit - I can visit doctors who charges only what Medicare will pay them, or I can choose doctors who charge a higher rate and pay the gap. The US would seem to be the only 1st world country where one can be bankrupted by getting sick.

You're obviously an intelligent bloke - what are the arguments for the US system? Economically? Wouldn't seem to be - you're getting ripped off with the most expensive system in the world with terrible outcomes. Your workforce is less mobile because the employer often provides health insurance hampering your ability to change jobs.

Outcome? Nope - the US has one of the lowest life expectancies in the developed world and poor rates of infant mortality (http://bit.ly/C99FK)

Freedom? Well, I guess you may have a more market driven system, but I get to choose which doctor I see. Does your health insurer (because I presume you pay for one?) let you choose your doctor or specialist?

What's even funnier is that a Christian such as yourself seems to favour a system that bankrupts people who get sick, and damns the poor who can't afford a doctor. And for what? A more expensive system which lines the pockets of private health insurers and doctors but has the worst outcomes in the developed world.

There are some great universal health care systems out there and many different models (check out Singapore's for example - it's a pretty interesting system: http://bit.ly/11MYXx ) - you really should look into it more.
 

dkam,

I'd be the first one in line along with you to say that the U.S. medical system needs a kick in the pants. There is a ton of waste as it stands. It seems that with malpractice suits combined with heavy, burdensome regulation, we are led here to a very expensive system that often over-treats symptoms (out of fearing of being sued for not doing what's commonly 'accepted'), and rarely addresses the cause.

That said, much of my experience is with Canada's health care system, and Argentina's. I lived in Argentina for two years, and I was RELIEVED to come back home. I knew many people who died from cancer just because the waiting line for treatment was too long.

It seems to me that voting for my neighbor to pay for the poor's health care is as virtuous as me robbing him of his property and giving it to someone else that I deem need it more: I think that's not mine to judge. I believe it better (and happier) to donate generously of your own free will than to have your property forcefully taken from you through government, to be used by the government not necessarily as you deem would do the most good.

I'll end by reiterating that it seems that we both want the same thing: we want more people to receive better health care. How much medical progress has been made in the last 100 years? Under what economic system were the majority of those advancements made? It seems that if we sold out an economic system in order to secure for ourselves the fruits that it gave us, the fruit would quickly disappear. (and yes, I do believe we have already drifted from that system - refer to first paragraph)
 

Also... I haven't had a problem switching jobs because of health insurance, though I admit I can see when it would be prohibitive for people. I think the whole "getting insurance through your work" thing is a sham.

I do have a choice of who I can see (mostly). I've went to a Naturopath before and have paid out of my pocket, and had good success there. I've also seen an internal medicine specialist, who was more holistic (and cured me by helping me change my diet rather than take pills) - insurance paid for that visit, but not for the dietary supplements subscribed. With Health Savings Accounts you get more flexibility with how you spend your money on health care. (and quite honestly, I think Health Savings Accounts with a high deductible insurance are the way to go!).

I personally know a family that is struggling very hard financial right now - they are good friends of mine. The mom in this family made it through cancer. She had no insurance. She got great care. She just had to get a pace maker installed. The doctor performed the operation for free, out of charity. Overall they are in debt through this - but they still have their home, they still have their cars, and people are pitching in to help them with the bills.

It seems to me that US lifestyle and diet may be playing just as big or bigger of a role in life expectancy and quality of life than our the health care system.

I would like to see us go back to a system where productivity is the standard: better for less is the weapon of competition and competition is so fierce that the greedy are mulled over by the ambitious. I've seen what the government has done to education, to retirement plans, with the bailout plan, etc. I think the government should stick to serving the people by defending rights and establishing justice, and stop trying to behave as the provider of all things and acting like it's magic wand of force is the answer to making all things better.
 

The strangest part of the discussion, to me, is the very libertarian idea that paying taxes is the same as someone stealing from you.

I see you submitting your code on GitHub - you obviously agree that sharing enriches everybody. A similar argument can be mounted with goods and services. For example, the government has "stolen" your money to build roads, bridges, schools, police forces and a justice system. Because of these shared systems, everyone is better off. Without a police and Justice system, there would be nobody to enforce rights. Healthcare is another such service. Everyone is enriched when you have high quality, public services - including health systems.

Now, I'm the first to agree that one man should be rewarded directly for his ingenuity and labour. I'm very much a believer in free markets and free trade. But there's merit in shared public infrastructure and service. Taxes are used (or should be used) for the betterment of these services. Sending troops after non existent WMDs doesn't qualify.

When you say "Under what economic system were the majority of those advancements made?" - are you suggesting most of the advances in medicine are from the US? While I'm the first to agree the US is a powerhouse of innovation, claiming that the majority of medical advances come from the US is a bit over the top.

I can't imagine the stressfulness of the situation your friend's mum finds herself. It would be terrifying to be a parent and then contract cancer without insurance under the US system. The situation is dire enough, without the fear of bankrupting your family. I have friends and families here who've had or have cancer - all their medical care are covered though the public system. I'm completely happy that my taxes have gone to help people like them.

Health Savings Accounts sound interesting - I'm not sure if you had a look at the model used in Singapore, but it seems to be somewhat analogous. My understanding of the system is that funds are deposited into your medical account by your employer. I suspect they're mandatory for all working people - probably a percentage of your income. Similar to Superannuation in Australia. The funds can only be spent on medical expenses, and the government provides "Calamity Insurance" - basically covering life threatening, expensive procedures if your account can't cover it. It's an interesting combination of systems - the services you buy are competing for your business, and to a degree, you're spending your own money (money that can only be spent on healthcare).

The irony of the situation is, the US government pays almost as much as per capita as here in Australia (almost double when including private funds)- yet the US has much higher child mortality rates and lower life expectancies. I'm not sure how US lifestyle Vs Australian lifestyle effects the outcome - probably not as much as you might imagine - Australia's going through it's own obesity epidemic right now.

I'm sympathetic to the argument that government provided services aren't subject to competition or at least, much reduced competition. But I don't think healthcare is really the type of service you want strong competition in - profiting from denying the best possible health care? When I go to the doctor or when I've had surgery, the last thing I want to think about is if the hospital will be doing their upmost to keep me safe and healthy. Or will they be saving some money by reducing the level of care I'm receiving?

After living in 3 countries with free public health systems, I'd not trade it for the alternative.
 

I'm suggesting that innovation occurs under systems that are free from burdensome government regulation, in other words.

What do you believe the proper role of government is for? Is there a point when government is excessive?

What are examples of things worthy of using taxes? What are examples of things taxes shouldn't be used for? Do you believe the government should provide food for us all? Why or why not?
 

Germany has had universal health care dating back over 120 years, and is lauded as having some of the best health care in the world, provided via a mix of public and private insurance.

Some of the world's largest pharmaceutical companies are based in Germany, including Boehringer Ingelheim, Bayer, and Merck, not to mention some of the greatest medical research in the world. So one can hardly say that universal health care has stifled innovation there.

Universal health care can be an astounding success. It's all in how one does it.
 

I don't enjoy dispute for the sake of dispute, so I'll speak plainly and honestly.

It seems in order to establish what is good and bad government policy, we need to define a standard on which to base our assessments. As such, I propose the following: the protection of the people from abuses in government power. I believe that this is the only standard that does not conflict with any other worthy cause, such as the seeking the health and well-being of all mankind.

You make the claim that Universal Health Care can work: it's all about how you it's implemented. Well, by the same standard, a monarchy can work, so long as you have a good king that doesn't thirst after power, but rather seeks the welfare and freedom of those governed. But what happens when a bad king gets in power?

It's deceptive to make the argument that good government is a question of being to the left or to the right. The answer to good government, one where the people generally enjoy freedom from abuses of power, is in a people's government: one where the majority of power is held down at the local level (down to the family unit), and the least power is held up at top (think pyramid).

By this standard, it seems that National Health Care is incompatible with good policy, regardless of whether it can accomplish the objective it's set out to do. It places more power in the hands of the central government, increasing the opportunity for abuse (have you seen the mess of bureaucracy they're creating to implement this scheme? It seems that power seekers often hide behind complicating things). Furthermore, with people depending more and more on the government as the provider of goods and services, it fosters a mentality of dependence, further exposing the them to opportunity for abuses in power. If we are to be a free people, we must look to ourselves (and only in dire circumstances: our families, communities, churches, etc.) to provide for ourselves and accomplish the objectives we deem worthy. We must be self-reliant.

You and I both want people to receive the care they need. No man with a heart would desire otherwise. The deception is that the way to accomplish such a thing is to give more power to the central government and look to them to do what we believe ourselves incompetent to do on our own. It appears that such thinking stems from laziness and the mentality of the dependent. The truth is, everyone of us can exercise compassion and give of our own substance to help the poor, right here, right now, without the government! Private, voluntary charity not only works, but I would submit that it's the only form of charity, and that all other forms are counterfeit.

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One more thing - from dkam's comments it seems his premise is that I approve wholly of our current system of Health Care. Such a premise would be flawed.

I have some ideas that I plan to articulate later on what I believe are the causes of the disease we have in our current system, and what it seems we must do to solve them. As time is short, I'll suffice at that for now.
 

Here is a facebook wall conversation I had

"An increase in taxes is a small price to pay if it insures healthcare for EVERYONE! To just 'work for your own' is a selfish attitude and that's why things are the way they are now! Watch the movie 'SICKO'!"

My response:
"Yes but the dropout rate is already off the charts for pre-med students in america. We might have health care for all but in 10 years there will be no doctors to take care of the sick for free - Just a thought"
 

Hah, no kidding. It seems those who like to fling mud at the self-reliance advocators either miss or choose to ignore the voluntary redistribution of wealth piece of the equation. I've heard that people generally view the world as they view themselves, so in that context it seems your friend has given us a good idea of how he views himself.

“If you're not a liberal at twenty you have no heart, if you're not a conservative at forty you have no brain" - Winston Churchill
 

As a follow up on this FB thread:

Cicely Senten Chris Larson- I thought being a doctor was about helping and healing not making a 100,000$ paycheck! Granted doctors shouldn't work for free however, if teachers can work and live off of so much money why couldn't doctors?!

Response:
chris Larson - Cicely Senten - Really!? Really!? - $500,000 in student loans and the 8 years + of schooling which doesn't include a speciality. What you're asking for is equal pay for all no mater the profession. That's just silly - The reward is helping people but the benefit is the salary (justified for all the hours a Dr. has to put in durning residency and beyond)

All I can say is UGH!
 

One step that needs to be taken in order to make our health care system better without reducing freedom or increasing government power is to move towards eliminating all incentives for employers to provide health care for employees. By removing the government from the equation, the system can work in a more free market. If employers don't choose my health insurance, then I have to go shop around and find health insurance for myself. In this manner, I get more choice over what kind of insurance I get (and more choices for doctors is implied). Once people start shopping around, free market competition will heat up, reducing costs.

One logical fallacy that I notice being repeated over and over is that because <name-your-favorite-country> has Universal health care and because it has better life expectancy rates than the U.S., it must work better than our health system. Repeat after me: "correlation does not mean causation". This means that while life expectancy rates may be correlated with universal health care, it is a logical fallacy to jump to the conclusion that universal health care is the cause of better life expectancy rates. It is much harder to prove the cause of something than it is to prove correlation. There are many factors involved with life expectancy rates getting better, including eating habits, homicide rates, smoking rates and on and on and on.
 

John Stossel's report on health care:

http://www.youtube.com/watch?v=kf3MtjMBWx4&feature=related
 

I agree with some of these comments. I don't think any American wants the British system (single payer healthcare - nothing else).

However, you totally leave out the fact that our healthcare system is already highly regulated by a fractured state system and massive bureaucracy.

What we need is a minimal federal standard of healthcare, consistent state level standards that foster innovation, and a marketplace for individual health insurance plans including government-funded and hybrid plans.

In addition to that, there needs to be a free safety net insurance that pays for regular checkups, injuries, and catastrophic care with a high deductible. This will obviate the need for medicare and medicaid.
 

@Adam N
"However, you totally leave out the fact that our healthcare system is already highly regulated by a fractured state system and massive bureaucracy."

This is very true. However, I think anyone who believes the bureaucracy won't get worse if the government gets even more involved is fooling themselves. What we need is deregulation of the health care industry. We should move toward gradually removing the multitudinous regulations so the market can operate. What we have right now is not a free market, (45% of ALL health care spending in the U.S. comes from government) so it's not fair at all to say the free market has failed to reduce costs in health care.

Government health insurance competing against private health insurance is not fair at all. Competing against a government with legislative power is a no-win battle, no matter how cheap the actual costs may be on the private side of things.
 

@Eddie

I agree with your points - but that's totally doable with a 'no unfair competition' clause that mandates that the government be on a level playing field with the insurance industry (i.e. all rules are applicable to all companies and government entities and hybrids).

There are plenty of government entities that don't have legislative power and have to lobby like any other special interest group (i.e. the VA, the Fed, etc... - the Fed still doesn't have the power to regulate insurance companies or non-bank financial entities). Legislative power is in the legislature, the executive leadership, and the courts.

My 'best' solution would be a level playing field, government backed insurance schemes, no deductions for medical costs below 15% of income, and high deductibles. There should also be one plan that is a safety net that makes all it's money from high deductibles and tax but is free to people without other insurance.
 

@Adam
I do acknowledge that it is possible to compete against government if it is setup properly. But that still doesn't address the question of whether the government will be efficient at it, or whether it is even constitutional. And let's suppose that health care is setup to allow competition in the private sector... It is still possible in the future for the legislature to change it and deny the "fair competition". I even have an example where this has happened. There is actually a rule on the books (United States Code) that makes it ILLEGAL to deliver first-class mail, unless of course you are the government. So the United States Postal Service still has a monopoly on first class mail, to this day.... and despite that, they can't turn a profit. The USPS is in the red by billions of dollars. Why do we let government burn through our tax money this way? Whenever a government enters business, it fails to profit because it doesn't have to profit to stay alive. With no profit motive, it's no wonder they lose money... why profit when you don't have to? With an endless taxpayer base to leech from, the USPS will be here for ever no matter how badly it does. So it really doesn't make sense to let the government engage in any kind of business. But the main reason it shouldn't engage in business isn't because it won't be profitable but because that's not the purpose of government.
I think we should be VERY careful about creating any new government entities/programs/entitlement because once they are here, they're (sadly) here to stay.
 

@Eddie - I think it's clear that you have a 'The government is too lumbering to do anything" bias. It's ok, we all have biases.

For instance, I'm biased to be pro-choice, mostly because my mom raised me that way. I can't honestly say that I have a good sense of why that should be - I certainly know all the arguments.

Anyway, as far as government-run healthcare ending up like the USPS, you give some fallacious examples.

1. The Post Office is currently in the red, yes. However, it hasn't taken government money for over a decade if not more. All organizations go in and out of deficit, it's quite normal.
2. The USPS, let's be serious, is one of the best run organizations in the world. For 44 cents, I can send a physical document from my apartment in New York to rural Utah in under a week.
3. If the USPS weren't given a monopoly on first class mail, then it couldn't be compelled to deliver universal service. Therefore, rural areas would be totally cut off since it's unprofitable (except for $25 FedEx letters). Personally, as a city dweller, I think this would fine if the rural people decided this is what they wanted. However, the truth of the matter is that USPS customers in the cities, which have more efficient routes, are subsidizing rural America's delivery system.

That's exactly what will happen with health care as well - the rich, populated areas will subsidize the poor, rural areas.

Am I missing something about your argument? Are you saying that the USPS isn't a well-run institution (considering it's mandates)?
 

@Adam

In light of the US Post Office topic brought up, I found this interesting: http://is.gd/3Poez
 

Heh, interesting article :-) Don't get me wrong - I'm not generally pro-union (in these types of situations in particular).

And I definitely think the government has some major problems.

And I don't think healthcare is a right.

I just think that a basic public option best balances the healthcare needs of the country right now with the need to control costs. We effectively already have public options - Medicare, Medicaid, VA, state plans, and emergency rooms. It just needs to be made nominally rationalized with a basic default public option.
 

@Adam.

Thanks for the comments. I admit that you make some good points.

1. I don't think the USPS necessarily needs to have a monopoly on first class mail in order to be mandated to deliver there. Perhaps some legislation could be passed that releases their monopoly while simultaneously mandating that it still continue to deliver there. Just a thought.

2. Given government waste in health care currently, I really don't see how more government involvement will help control total costs (not just cost of insurance--we're talking taxpayer costs too). I'm admittedly not putting forth an additional argument that hasn't already been stated in this thread... just re-hashing. It would be interesting to see studies on government involvement in cost control and how effective they are.

Now, I honestly want to know the answer to this question.... How can the USPS not take government money, and be in the red? I am ignorant in these things.
 

@Eddie

The USPS is in the red because it doesn't take money from the government. If they did, they'd be in the black.

In addition, because the USPS is a federal entity, it has to record debts now as opposed to in the future - including all of their future liabilities with regards to pensions etc... If other companies had to do that like John Deere, they'd be much farther in the red than their books let on.

As for waste, I can't think of any large organizations that don't waste. The US Military is the best run in the world IMHO, but there's plenty of waste there. Giving less money to the military would certainly reduce waste, but it would also reduce it's effectiveness. Increasing money that goes to it would increase it's effectiveness and also increase waste.

Nobody wants to see waste, but it's not something that will disappear by fiat.

This discussion is really about the moral and inefficiency issues of our current health care system.

This video has some information:

http://www.pbs.org/now/shows/health-care-reform/index.html
 

I just ran across this blog post that makes a really good description of the costs of different types of economic models:

http://kirkbyfamily.blogspot.com/2009/09/economics-of-free-healthcare-or-why.html

If legislation were to be introduced (even legislation which happens to involve the government more) that could be convincingly demonstrated to cause consumers to act much more like the "Laissez-faire" model described in the post above, rather than the "insurance" model we currently use, then I may be convinced to support it.

@Adam,.. I find general arguments that run against this type of common-sense, human-nature opportunity cost model quite unconvincing... Just so you know where I'm coming from in my thoughts about govt inefficiency. :)