Both in rich and poor countries, universal health care brings huge benefits • Hacker News Board

Re: Both in rich and poor countries, universal health care brings huge benefits

#221

Post by frgtpsswrdlame » Wed, May 02, 2018, 3:42 PM UTC

Consultant32452 wrote: post #173

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

I don't see how you can define the state taking money from the wealthy to buy healthcare for the poor as violently coercive but not also define a corporation withholding necessary care from a poor person as violently coercive.

Re: Both in rich and poor countries, universal health care brings huge benefits

#222

Post by Consultant32452 » Wed, May 02, 2018, 3:43 PM UTC

fogzen wrote: post #206

Consultant32452 wrote: post #173

Earlier quoted context omitted.

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

Law is violent coercion. This isn’t libertarian philosophy class, it’s the real world. In many places in the real world, universal government insurance is already in place. This isn’t some hypothetical.

The fact that some people or nations behave in a particular way does not in any way determine whether that behavior is moral.

Re: Both in rich and poor countries, universal health care brings huge benefits

#223

Post by sykh » Wed, May 02, 2018, 3:43 PM UTC

chimeracoder wrote: post #189

creaghpatr wrote: post #164

Earlier quoted context omitted.

>Do Medicare recipients seek to leave it? No, because it's free, but 1/3 of Medicare recipients opt to receive their coverage through private insurers that typically add on additional coverage, an indicator that Medicare alone is not enough for a large segment of the population, or that they prefer a private insurer even with government subsidization. https://www.kff.org/medicare/fact-sheet/medicare-advantage/

> No, because it's free, but 1/3 of Medicare recipients opt to receive their coverage through private insurers that typically add on additional coverage They don't simply add on coverage; they replace it. Most people on Medicare Advantage don't opt for coverage above what Medicare itself can provide - they simply receive their benefits from a private entity instead of Medicare, because Medicare provides such a bad ex…

Private entities contract with Medicare to provide insurance that covers what Medicare covers (and perhaps more). Would said insurers cover everyone that Medicare covers in the absence of Medicare? The answer is no.

How many of these people on private Medicare plans pay for Medigap? Everyone who get kicked off a private plan can go back to the original Medicare. Your point is disingenuous. Medicare is the universal insurer of last resort for elderly. Their lives would be much worse without this last resort insurer.

Re: Both in rich and poor countries, universal health care brings huge benefits

#224

Post by dv_dt » Wed, May 02, 2018, 3:43 PM UTC

SamReidHughes wrote: post #146

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

What if they're not an American citizen? What if they're also in a different country?

Care for them under the universal system, but bill the cost of the universal system directly.

Re: Both in rich and poor countries, universal health care brings huge benefits

#225

Post by rogerb » Wed, May 02, 2018, 3:44 PM UTC

SamReidHughes wrote: post #194

rogerb wrote: post #172

Earlier quoted context omitted.

My position is to take care of that person, like weve been taken care of visiting while other countries, but trying to avoid the illegal/undocumented immigrant strawman for clarity.

Okay, but what about people in other countries? Why don't we have an obligation to help them, to?

That's a different question which is outside of the scope of healthcare in the US IMO.

Re: Both in rich and poor countries, universal health care brings huge benefits

#226

Post by fastball » Wed, May 02, 2018, 3:44 PM UTC

sykh wrote: post #121

rukittenme wrote: post #66

Earlier quoted context omitted.

> When it comes to public funding for public goods we tend to worry about some poor person getting something they don’t deserve. The go it alone I’ve got mine, fuck you attitude is unhealthy. 1/3 of our GDP goes to "the village". We spend trillions every year on the things you want most . Education, healthcare, environmental protections. You name it; we spend money on it! 70 million people use medicaid. 44 million pe…

Our spending on healthcare is grossly and immorally inefficient. A change is needed. One reason for the ineffiency is that public welfare is subordinate to special interests. All universal healthcare systems in the world are cheaper on a per capita basis than the American system. A change is needed. I’m not advocating for more money. I’m advocating for a change in perspective by our leaders.

Just because something has worked for other countries does not mean it will work for the US.

Re: Both in rich and poor countries, universal health care brings huge benefits

#227

Post by kalleboo » Wed, May 02, 2018, 3:45 PM UTC

adaml_623 wrote: post #4

Just going to throw this out there. Non universal health care is analogous to half the roads in a city being toll roads. Society can still function and you can mostly get to where you're going but it's not close to efficient.

Interestingly I live in a country (Japan) where all the highways are privatized and made into toll roads. Driving 3 hours to the next big city over costs nearly as much in gas+tolls as taking the high-speed rail (which takes half the time). To me for transport making costs transparent actually makes things more efficient.

We still have universal healthcare though.

Re: Both in rich and poor countries, universal health care brings huge benefits

#228

Post by sykh » Wed, May 02, 2018, 3:45 PM UTC

conanbatt wrote: post #193

sykh wrote: post #154

Earlier quoted context omitted.

Your first paragraph is false and indeed can not be true in any system that rations care. All health care systems ration care since no soceity has enough resources to cover and pay for all possible needed health services. Here resources includes number of qualified workers.

If its rationed then some people are going to be left out, and the moral argument crumbles, as people that need it don't get it.

The rationing can be in a moral way or in an immoral way. All systems ration care. Most do so in a much more morally palatable way than the U.S.

Re: Both in rich and poor countries, universal health care brings huge benefits

#229

Post by fastball » Wed, May 02, 2018, 3:45 PM UTC

sykh wrote: post #6

When a person gets a life threatening disease they ought not worry about whether or not their treatment will leave their family in penury. This is especially so in a nation as wealthy as the U.S. The American healthcare system is immoral and I hope it drastically changes. Americans need to change their underlying notions of what it means to be a society. An author was once made fun of for suggesting that it takes a v…

It's immoral for people to pay for the time and work of others?

Re: Both in rich and poor countries, universal health care brings huge benefits

#230

Post by ska » Wed, May 02, 2018, 3:45 PM UTC

Consultant32452 wrote: post #173

rogerb wrote: post #131

Earlier quoted context omitted.

There's a simple thought experiment that helps: - an american citizen break his leg, he is not insured. Do you A: let him die B: take care of him ? if your answer is A - you are a terrible person, but you hold a consistent position. if your answer is B - the only question that remains is what is the most economic, efficient way to take care of this person ? b is universal health care. if you think you can do A with e…

The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that the person is either able to pay for it, or the cost through charity is trivial. This has the double benefit of not attempting to rectify one moral wrong (person does not receive care) by committing another (violent coercion by the state).

   The most economically efficient way to pay for B is to allow the free market to drive the cost of care so low that...

Talking about free market efficiencies is a bit like talking about the effect of Newtonian forces on a spherical cow. Very useful to learn from in an undergrad setting but rarely sufficient to capture real world systems.

What you actually want from policy is something like a trajectory toward the best expected result in existing markets over reasonable times. This is much more practical than a provably optimal result in an oversimplified model. Models can be very useful, but the map is not the territory.