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

economist.com

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

#381

Post by DanBC »

wl78393 wrote: post #165

Tell that to little Alfie. When you have an unconditional "right" to consume someone else's labor, the inevitable result is tyranny, rationing and the force of government determining outcomes.

If you're going to read anything about this at least read the latest court case: https://www.judiciary.gov.uk/judgments/thomas-evans-v-alder-...

It's short. It's simple to understand. It's clear about the legal principles.

Also, you should probably read something about the terrible legal advice provided by CLC.

https://nearlylegal.co.uk/2018/04/on-the-naughty-step-the-qu...

https://www.theguardian.com/uk-news/2018/apr/28/call-from-go...

Alfie Evans got 16 months of world class health care.

When he got to the point where treating him was futile and doctors wanted to turn off life-support they needed to get the agreement of the parents. Because the parents didn't agree the hospital needed to go to court. The hospital was not allowed to go ahead without a court order giving them permission. This is unlike California and Virginia, where the doctors announce the plan and then the parents have to sue to stop it happening.

For the court process the parents had excellent legal representation paid for by the state. The parents went through seven firms of solicitors and a counsel team of top class silk plus two juniors, because they disagreed with the legal advice each firm gave them. They eventually wound up being represented by the CLC - someone who isn't a solicitor gave them terrible legal advice.

On top of that Alfie had his own, independent, legal representation. This is because Alfie was a human, and humans have rights, and we protect human rights that are enshrined in our law and in international law.

The courts had the power to get independent medical advice, which they did. Every single doctor agreed - treatment was futile; Alfie had no brain; he was going to die and die soon.

The courts decided that it wasn't possible to say that further treatment would not cause more pain and suffering to Alfie, and they ordered that it was in his best interests to remove life support. It's important to note that no hospital was offering anything other than end-of-life care.

The parents disagreed, and took the case up through appeal, then supreme court, then Europe, and back again. This is many different judges, and the all agreed: it was in Alfie's best interests to let him die. (Europe agreed that Alfie's best interests had been kept in mind.

The court cases are available online, and you should read them, because they are short and easy to read and the principles are clear: everything has to be done in Alfie's best interest; the parent's views are important but they don't own Alfie.

So, you seem to say that we did it wrong, and that the US would do it better.

In the UK the hospital had to go to court.

In eg California that is reversed. The doctors tell the family they're going to stop treatment, and the family have to go to court to stop the hospital. Who pays the legal bills for the family? Who pays the legal bills for the child?

http://medicalfutility.blogspot.co.uk/2018/04/medical-futili...

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

#382

Post by monocasa »

chimeracoder wrote: post #369
monocasa wrote: post #363

Earlier quoted context omitted.

First off, the VA isn't as bad as you're making it out to be. https://www.rand.org/news/press/2016/07/18.html "Quality of Care in VA Health System Compares Well to Other Health Settings" A lot of the bad press around it's deficiencies are because it, as a public institution, publishes a lot of information that the private healthcare system isn't required to publish. And yes, having been from Newt Gingrich's district,…

> First off, the VA isn't as bad as you're making it out to be. From your own link, which is a press release by the firm which sponsored the research: > Researchers say there were few studies [included in this meta-analyis] to evaluate equity, efficiency and patient-centeredness, and that the quality of the available studies vary. Incidentally, those are three of the four main issues for which people typically critic…

> From your own link, which is a press release by the firm which sponsored the research:

I mean, it's the Rand Corporation. It's not like it's some fly by night 'you pay us and we'll say whatever you want' firm. The link to the real study is right there.

> Incidentally, those are three of the four main issues for which people typically criticize the VA.

That statement was for the whole study, including the private side. Once again, the VA publishes quite a bit of this information, when was the last time you saw average wait times for the private side?

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

#383

Post by Consultant32452 »

aninhumer wrote: post #306
Consultant32452 wrote: post #281

Earlier quoted context omitted.

Doing nothing is not violent or coercive. It may be morally wrong for a person to do nothing, but it's not violent or coercive.

If you are able to help them, and you refuse to do so unless they do something for you (i.e. labour to earn money to pay your fees) then it is absolutely coercive.

By that measure any salary a doctor demands, whether it's paid for by the patient or the state, is coercive. Or for that matter, any salary any person demands in exchange for work is coercive. I feel like it ceases to have a useful meaning when used in this way.

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

#384

Post by tonyarkles »

bdamm wrote: post #307
analog31 wrote: post #238

Earlier quoted context omitted.

My mom got injured while hiking in a country with universal care. She hobbled to the next town, found a clinic, and got treated. Then she wanted to pay. First, the person at the clinic said: "What do you mean, you don't pay for health care." My mom explained that she was from another country. It turned out they didn't even have the means to take her money. Treating a few foreigners for free might actually be cheaper…

Evidently she was not hiking in Canada, where they definitely will treat you and then make sure you the tourist does pay the sizeable (though not USA exorbitant) bill. The Canadian system in fact does have many payers; federal, provincial, private insurers, are all payers.

I'm a Canadian, but accidentally let my health card lapse right around the same time I had a fall that tweaked my wrist. At the clinic I went to, they explained that I would have to pay cash for the visit and to keep the receipt because it would be reimbursed by the provincial ministry of health once I got my card renewed.

Had a visit with a GP, he sent me next door for Digital X-Rays, and then I went back to to the GP where he looked at them and sent me home with a brace (no break).

GP visits: $25 X-Rays: $25 Brace: $15

I don't think I ever ended up submitting the receipts to SaskHealth... Just wasn't that big of a concern :)

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

#385

Post by Consultant32452 »

frgtpsswrdlame wrote: post #305
Consultant32452 wrote: post #281

Earlier quoted context omitted.

Doing nothing is not violent or coercive. It may be morally wrong for a person to do nothing, but it's not violent or coercive.

I disagree with the asymmetry. Withholding care isn't actually 'doing nothing' and has the ability to be violent or coercive. Take a life-saving but expensive pill. 'Doing nothing' in the case of someone who needs but can't afford the pill would be actually doing nothing - that person could waltz in, walk behind the counter, take the pill, swallow and walk out. Bada-bing bada boom, problem solved no violence or coerc…

Demanding to be paid for your work is not coercive. Otherwise every person in every situation who demands to be paid for their work, including doctors who demand to be paid by the state in a universal healthcare system are all being coercive. When taken to that level, the word coerce ceases to have a useful meaning.

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

#386

Post by Andre_Wanglin »

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…

>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.

If no one has to worry about the monetary effects of their health choices, poor health choices are incentivized and those who make poor choices are subsidized by those who make good health decisions. The vast majority of healthcare spending in the US is already on preventable chronic conditions yet everyone keeps gorging themselves further into obesity, diabetes, hypertension, CVD, etc. Almost no one is against paying into a risk pool that hedges against unforeseen health problems even though they may never directly benefit. If I pay my entire life to cover someone else's cancer, that's fine with me. What we are sure as hell opposed to is a creating an entire system based on perverse incentives that punishes people doing their best to save their pool from spending on them and rewards those whose voluntary actions are the driving force behind increased costs. And the US healthcare industry is not some libertarian wild west show, it is highly regulated and dominated by the edicts of CMS yet the state of the public's health continues to worsen in ways our forebears who optimistically, though naively, created these programs could never imagine.

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

#387

Post by SilasX »

slantedview wrote: post #379
SilasX wrote: post #367

Earlier quoted context omitted.

But that also means that if you could fix the cost bloat, it would be much easier to provide universal coverage, and that trying to do the latter before addressing the former is bound to fail.

Costs are high, largely, because we have a fragmented mess of a system rather than a single payer.

How do you know that that, rather than something else, accounts for the high costs?

Edit: for example, Scott Alexander's point about US providers feeling they have to provide expensive treatment just to cover the possibility of a lawsuit: http://slatestarcodex.com/2017/02/09/considerations-on-cost-...

Edit2: Also, Germany, the Netherlands, Singapore, and several others have typical cost savings but aren't single payer.

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

#388

Post by ataturk »

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…

[dead]

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

#389

Post by Andre_Wanglin »

sykh wrote: post #175
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/

Excellent. We are in agreement that the American government can and does provide a health insurance program that covers lots of people and has the property that people don’t seek to leave it. Perhaps the idea that everyone be covered in such a system is not so far fetched.

Why would anyone refuse free money? Are you sure you understand the parent's point? They are taking the money but using private networks, which indicates they prefer private providers.

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

#390

Post by ataturk »

analog31 wrote: post #238
dv_dt wrote: post #224

Earlier quoted context omitted.

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

My mom got injured while hiking in a country with universal care. She hobbled to the next town, found a clinic, and got treated. Then she wanted to pay. First, the person at the clinic said: "What do you mean, you don't pay for health care." My mom explained that she was from another country. It turned out they didn't even have the means to take her money. Treating a few foreigners for free might actually be cheaper…

It's not free. It has never been free. Just because strangers forfeit some of their wealth at the point of a gun doesn't make it free.
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