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

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

#451

Earlier quoted context omitted.

I don't think emotional arguments are a distraction, they're the whole point. This is a moral issue. Other countries manage to have universal healthcare and it doesn't break the bank. In fact, they spend less per person. The fiscal argument is the distraction.

> I don't think emotional arguments are a distraction, they're the whole point. This is a moral issue. I find the moral argument to be disingenuous. It is immoral to make poor people pay a tax that cure the diseases of rich people. "Nobody should go hungry, so everyone should be able to eat anywhere they want and not look at the tab".

> "Nobody should go hungry, so everyone should be able to eat anywhere they want and not look at the tab".

This is a violation of the most oft-ignored HN guideline: "Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize."

What the moral argument side is saying is that it is immoral for a country this rich to not provide socialized healthcare up to a certain level. What level, specifically? I don't know. I'm guessing it would probably include a diabetic's insulin, and would not include a smoker's lung transplant. The point is, (according to the argument you're disagreeing with) there is a level and it should be higher than it is now.

What you did with your straw-man quote - "everyone should be able to eat anywhere they want and not look at the tab" is set the level at infinity, so that the argument is trivially wrong and easy to defeat. You've done the same elsewhere: "The logical consequence of this is that any cost must be paid" and "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." This doesn't get us anywhere.

Try, before responding to an argument, paraphrasing it such that the person who you're arguing with would agree. If you can't do that - if you can't restate their position in a way that they would say, "Yeah, that is indeed my position" - then you don't understand it well enough to argue against it.

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

#452

Earlier quoted context omitted.

>The US has been developing its health care system, uninterrupted, longer than other nations. Can you describe this vis-a-vis England or France? I am confused as to how you think the US has been at healthcare longer or how an interruption occurs.

France was conquered roughly 70 years ago. England was not conquered, but I suspect WW2 had a near significant impact upon domestic government operation. According to Wikipedia the US health system has roots that go back much further without noticeable disruption: https://en.wikipedia.org/wiki/Health_insurance_in_the_United...

What about, say, Sweden, Ireland, Portugal, Canada, Australia, or New Zealand?

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

#453

Earlier quoted context omitted.

It's not a great comparison for a lot of reasons (not least of which the first being that Medicare is legally not able to negotiate drug prices), but despite all of that, yes Medicare is dramatically more efficient.

Medicare is the core of all regulatory and pricing issues in the healthcare space. And if medicare were expanded to the entire population of the us, its expenditures could be 40-45% of gdp.

> Medicare is the core of all regulatory and pricing issues in the healthcare space.

I can't see a reasonable argument for that.

> And if medicare were expanded to the entire population of the us, its expenditures could be 40-45% of gdp.

Even with a naive covered-population-number based extrapolation that ignores that Medicare currently covers the elderly, who tend to have greater medical needs than average, that's not right; national health expenditures are about 18% of GDP, Medicare is about 20% of NHE, and Medicare currently covers around 15% of the population, so a naive population-based extrapolation would put Medicare-for-all at about 24% of GDP.

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

#454

Earlier quoted context omitted.

> It seems the public interest is subordinate to private interests and often times with immoral consequences. This perspective of public vs private interest is rather puzzling to me -- it's more a matter of short-term vs long-term thinking. In the long-term, it's in the private interest of those having sustainable companies to have a broad base of educated and healthy workers to employ. The short-term interest of any…

> In the long-term, it's in the private interest of those having sustainable companies to have a broad base of educated and healthy workers to employ. Immigration affects this calculation significantly. If your long game is to be an attractive destination to healthy educated immigrants, investing in the "land of opportunities" mythology has better ROI than investing in universal healthcare.

Well, in this age, good luck finding enough "healthy, educated immigrants" who do not find the state of US healthcare system absolutely bonkers.

Maybe that's a good thing. Invite enough educated immigrants, and America will have more people saying "You know what, my country had a saner healthcare system thirty years ago when ordinary people couldn't afford air conditioners. What the hell is wrong with you America?"

(Yes, I'm speaking from my own experience.)

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

#455

Earlier quoted context omitted.

People go to "ER-or-equivalent". Immediately mentions a place that is not the same as ER that the US also has (clinics). As I said -- she was wrong to go to the ER. She lives in NJ. I know for a fact there are loads of clinics she could've gone to and been sent home with a clean bill of health for $50 copay.

I left NYC 5 years ago. But at the time I was living there, there was essentially no option other than an ER after 3pm (and very few before). And my point is that the European system does not require you to make decisions in such a case. You just go and get checked without going bankrupt. Where I live now I have 3 hospitals within 20 minute drive, one of which is walking distance, and 20 triage/clinic locations. I ca…

Really? I live in NYC and can't agree[1].

Yes, you are correct -- with a socialized system, you don't need to worry about "triaging yourself". But that is not a good thing. You don't want patients to mis-utilise the services available to them, just because they are free and therefore they don't need to worry about the associated costs.

Ambulances / ERs / MRI / etc -- these things are EXPENSIVE to operate. It's too bad, but it's the truth. Just because you can use them in the UK or wherever doesn't mean you should, and there is nothing to disincentivise people from this because they're not footing the bill (directly, that is). I literally wrote my undergraduate dissertation on various ways the cost of MRI could be brought down, and it's not an easy problem, regardless of who is paying for it. Getting medical care that you don't need is no small thing in the scheme of things.

1: https://www.google.com/search?q=urgent+care+center+nyc

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

#456
post #416

Earlier quoted context omitted.

The US government pays a huge amount on healthcare. This is whether you do it by total; by GDP; per capita. https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... If you include private insurance: > As a percentage of GDP, the UK spent less on healthcare than USA, Japan, France and Germany and a similar percentage to Canada. The USA spent the most on healthcare as a percentage of GDP at 16.6%. If you exclude…

You misinterpret or spin the data from your link. Look again and you'll see that, as far as compulsory spending goes the US and UK spend roughly the same percentage of GDP on "healthcare". What is "healthcare" as defined in this PR piece from the UK government? Where do factors like average wait time to see a specialist or have surgery weigh in? I could take those same numbers and say, "The United States does a bette…

> Look again and you'll see that, as far as compulsory spending goes the US and UK spend roughly the same percentage of GDP on "healthcare"

Yes, that's the point. The US government spends more on healthcare, but that huge spend doesn't cover the whole population.

> "The United States does a better job of assisting it's poorer citizens into the highest quality healthcare in the world,

Why does the US have such poor mortality figures if health care is so good and if everyone can access it?

> but I'd sure as hell take it over health authoritarianism, and the UK government proved that's what they have last week.

In the US cases of medical futility the doctors announce their plan to remove life support and if the parents disagree they have to go to court to stop it happening.

In the UK the doctors need to get the agreement of the parents, and if the parents don't agree the doctors have to go to court. In that court process the family can get legal aid (if they meet the financial test) - Alfie Evan's parents went through 7 legal firms, and they had expert counsel of a well respected silk and two juniors. But also Alfie had his own legal representation.

Alfie Evans had 16 months of excellent health care, followed by robust legal protection to make sure his best interests were looked after. His family are poor. He wouldn't have got anything like this in the US.

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

#457

Universal healthcare is not a silver bullet, in certain Eastern European Countries we pay a large amount of our salary in taxes so that we have universal healthcare and yet you still have to give "gifts" to every nurse and doctor that treats you unless you want the bare minimum treatment and care. Doctors can also intentionally botch surgeries if you fail to pay up. Not so much that it can be called malpraxis though.

We've managed to exactly formalize this system, and yet somehow it's viewed as less bad because it's an industry. America has managed to legitimize corruption.

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

#458
post #307

Earlier quoted context omitted.

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…

I'm a Canadian, living in America and therefore not a benefactor of Canada's healthcare system, even if I'm visiting Canada. On a trip to Canada a near car accident caused abdominal pain for my pregnant wife and a subsequent trip to urgent care to confirm if everything was OK. The bill was $600.

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

#459
post #366

Earlier quoted context omitted.

I don't think emotional arguments are a distraction, they're the whole point. This is a moral issue. Other countries manage to have universal healthcare and it doesn't break the bank. In fact, they spend less per person. The fiscal argument is the distraction.

"It is morally wrong that someone can die from X because they're poor" is a fine point to make. There's nothing wrong with moralizing in that sense, IMHO. The problem is when you add "And therefore the presence of profit making entities must be the cause". That inserts a moral argument as a substitute for identifying the core problem. I think that's the kind of error you're making here: >Other countries manage to hav…

You are correct. There are plenty of other factors that result in broken healthcare, broken prisons, broken public health, broken cities.

But what are they? What is the root cause resulting in the richest country in the world being so dysfunctional for so many of its own citizens?

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

#460

Earlier quoted context omitted.

France was conquered roughly 70 years ago. England was not conquered, but I suspect WW2 had a near significant impact upon domestic government operation. According to Wikipedia the US health system has roots that go back much further without noticeable disruption: https://en.wikipedia.org/wiki/Health_insurance_in_the_United...

What about, say, Sweden, Ireland, Portugal, Canada, Australia, or New Zealand?

I have no idea.
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