Socialized Health Insurance
Sunday 24 February 2008 - Filed under Politics
And, in another post, you said that universal health care is fiscally conservative. Dude, that is laughable, and yes, insane.
No, you’re bad at math. Right now we have a situation where millions of Americans without health insurance get no preventative care at all. So they wait until they are very sick before they go to the ER. They can’t pay their bill so the hospital is stuck with it. The rising cost of health care, among other things, reflects the fact that WE ALREADY PAY FOR THESE PEOPLE but we do so in a manner that gives them no access to preventative care and thus, it costs us much, much more.
This is a fact, by the way — that preventative care saves tons of money on the back end.
Add to this the fact that Medica, Blue Cross and all those other crooks make billions of dollars. Their business model? Make it a pain in the ass to collect benefits, both on the individual side and on the doctor’s side. Ask any doctor about it and they will tell you that those companies are professionals at dragging their feet and delaying or omitting payments. They add no value whatsoever. They just sit in the middle and get paid.
Finally, the cost of catastrophic health insurance isn’t that much! If we covered everyone with high-deductible policies that provided access from the 1st dollar to preventative care, compared to the amount of money pumped into the system today, we’d save billions of dollars. The whole point of insurance is to spread the risk around as much as possible. How about we spread it out among 3 billion people?
I thought Republicans were all about getting rid of waste? We waste money throughout the entire chain because you guys have a Red Scare called socialized medicine. We should not socialize medicine. We should absolutely socialize health insurance.
2008-02-24 » lolife
25 February 2008 @ 2:51 am
Interesting article. You are right, when talking about prevention. It is inevitable to widen prevention programs as much as possible. There is place for both insurance companies and state sector. Insurance companies should support preventive care not only to their clients, but to whole society – they never now, who they make contract with – so healthy population (not only their clients) means more money for them. And I think you said enough about global benefits for state, when inhabited by healthy citizens.
But you have to remember, that absolutely socialized health insurance is under constant risk of wasteful use of funds. It is a big problem for many european (especially postcommunist) countries – they pump huge money into system and they get no results.
You can find some crumbs about health insurance on our Toronto life insurance brokers webpage…
25 February 2008 @ 6:43 pm
This is my basic problem with liberal thinking…
You guys seem to think that if a system is broken (which I agree, the health care system is broken) then the solution is to hand it over to the fucking government to fix. Dude, it just doesn’t follow.
The only agency in the government that operates with any level of efficiency is the mail service. Ya know why? Because it has competition from UPS & FedEx. Competitive market forces are removed from the current health care system too because of the way HMOs work. There is no shopping for best prices, etc. Everything is paid through the insurance companies and the end user really has no idea how much stuff costs. They just complain when their premiums go up and they have no clue why.
Now I’m no expert in this area so I don’t have the answer but somehow market forces need to be injected into the system which is the oposite of what you are advocating which is to eliminate all market forces and socialize it. SOCIALISM DOESN”T WORK. It never has and it never will.
I believe everybody in the US should get affordable (or free, if that’s all they can afford) health care but I don’t agree with you that it should be done through the government. This needs to be done by making health care more affordable, not by mandating that the government pay for everyone.
The dirty little secret the liberals hide from you is that the majority of the “uninsured” in this country that would be forced into a universal payer system are young people who don’t want to pay for health care and for the most part don’t need it. They calculate (correctly in most cases) that they would pay and pay and for a service they would not need for quite a while. I believe health care savings accounts would be a much, much better option for those people.
25 February 2008 @ 10:16 pm
How long should it take for market forces to correct the broken health care system? ‘Cause it’s been their baby up until now. If they could fix it, they would have. In fact, they fucked it up!
Markets are great at some things but they have to be things that function well in an environment of greed. I would put schools and health care in the same boat, where the public good has to be the guiding principle, versus the good of the winners and the sorrow of the losers. In markets, some people lose. We can’t afford that in education and I think it is immoral, in this day and age, in this country, that we’d have losers on the health care side.
Socialism doesn’t work? Does it work in your family? It works in mine. We each contribute what we can and take what we need. How about the US armed forces? It is basically a socialist enterprise, where the many are more important than the few. You have been taught to consider socialism evil in all contexts and that is dogma.
Recall that the word socialism comes from the word society. Is society a bad thing? Of course not. What we do in society is band together for our common good. We have to be smart about what those things are. Do you think we should support the military? Then you are, to some extent, a socialist. Should we care for the sick?
I think the government has to choose its battles. We can’t do everything for everyone. But everyone, even the young people you mention, need healthcare. Every single person needs it, to some extent. (Recall that young people get pregnant, a very expensive ordeal.) Especially because the market has fucked it up, and because people are demanding action, it is an obvious place where we should band together for the public good.
The Right just thinks that they have to pay for it because they Right still thinks that they are rich and the Left is poor. That is a myth.
27 February 2008 @ 4:59 pm
Schools work great without market forces? Our public schools do not work great, in fact, a large portion of them suck. Most people who can afford it don’t even send their kids to public schools, even in good districts like the one I live in (196). One reason they don’t work is because of the lack of market forces. This is why school vouchers are an excellent idea because it would introduce market forces to the system. Private schools educate kids FOR LESS MONEY PER STUDENT then public schools. And don’t tell me it’s because public schools have to take everyone. That’s part of the stupidity of the left who pretty much wholly run the school system. There are kids in our public schools who should not be there because of political correctness. They should be cared for and educated as much as possible but not in the public schools. I know teachers and administrators in my district that will tell you that. Some of these kids have full time assistants that are charged to care for only a couple kids. This is not an efficient use of funds meant to educate our kids.
And the military is socialistic??? The left’s ignorance of the military is only matched by it’s loathing of it. If you told an army private that he was in a socialistic society where all were equal and distributed evenly for the public good, he would laugh in your face. The segregation of the officer class and the enlisted man class in the military is more akin to a caste system then a socialist state. Are there elements of socialism, sure, they get universal health care but it’s probably a good idea to feed your Army and patch them up when you’re putting them into harms way on a daily basis. Do you think we should have a soldier pay for their own operation to re-attach his severed leg? Using the Army as a model of how socialism can work is just absurd.
And yes, health care. Market forces are not at work in the health care system. We need to inject market forces into the system. Do you know how much a colonoscopy costs, or an x-ray, or a CT scan? Do you ever ask the cost for any procedure and then seek out the best deal? Nobody does. This is why I am in favor of health savings accounts to cover non-catastrophic services. Did you ever notice how much cheaper dental care (especially elective procedures), or optical care is than medical care for the most part. That’s because a lot of people have to shop around and actually pay for the procedures. The price of lasik surgery and stuff like that keeps COMING DOWN because of market forces. Why does the cost for that kind of stuff not rise like everything else in the health care system.
Dude, you’re wrong about universal health care, your wrong about the war in Irag, your and wrong about global warming (mark my words, we’ll be in a cooling trend for quite a while now due to another “Maunder Minimum” solar cycle).
And I started posted again because there were some conservative peeps in the house. Where’d they go???
27 February 2008 @ 5:04 pm
PS. Your wrong about Obama too. If he’s elected it will be a disaster for this country. I can’t believe a seemingly intelligent grown-up would want to vote for a candidate who is the 2008 political equivalent of a 1973 “I’d like to teach the world to sing” coke commercial.
Coke is a good analogy too, lots of fizz but no nutritional value.
29 February 2008 @ 12:06 pm
1. Schools. You have no idea what you are talking about. We have a constitutional mandate that public schools educate every child. Blake, by the way, charges $20,000 per school year for K-12 education. Public schools = free. Is the government paying the schools more than $20,000 per child per year? No, it’s more like $4000, a factor of 5 less.
2. The military. Thank you for making my point for me. Socialism has its place. Your Red Scare mentality about socialism is literally retarded. The notion that society acting cooperatively is a bad thing is just fucking insane.
3. There are virtually no government regulations on health care today. It is solely in the hands of the free market. What you are complaining about, the free market created. BTW, we are moving to health savings account at my business. I think it’s a great idea. It doesn’t change the fact at all that the free market created this mess.
4. Obama is very intelligent, articulate and has a lot of life experience and more government experience than the average citizen by far. More than say Bloomberg or Schwarzenegger had. We need someone with good judgment, good team building skills and someone who doesn’t favor ideology over facts. It appears that your objection to him is his focus on a positive message? WTF, dude. John Madden would be a better president that George W. Bush.
The reason the Right hates McCain, by the way, is because he is reasonable every once in a while! They hate that.
4 March 2008 @ 8:00 pm
My my. What vitriol! And some reasonable and unreasonable ideas by both lolife and micadelic. I feel like I should run out and buy a Fox40 whistle and a black and white striped shirt! I will comment on the thread-to-date.
“Universal health care”: first, it is important to use more words to define what you mean. lolife is probably correct that there are social benefits to a healthy population, even if there are some who are too poor to afford to buy it themselves. Frankly, micadelic, if you argue against that, I think you are not thinking clearly. I would very much prefer that the person next to me on a bus has had his or her shots, and am willing to pay for my share, though some might not. This places health care in the public sphere. (Although, frankly, it is not yet proven what the truly long-term effects of innoculations etc are, we only have a few decades of experience, and may just be creating super-bugs through the long-term process of evolution. I am selfish enough not to care about that future possibility) Even if we can agree on this, there still remains much to be reconciled.
Two areas that need to be addressed, are of funding, of delivery:
1) What are the mechanisms and processes by which we will deliver the subsidized service, keeping in mind we seek both quality and efficiency (ie low cost)?
2) How should we determine the appropriate level of subsidization of “the poor” by “the rich” in the specific areas of health care and education, and what are the mechanisms and processes we will use to perform that subsidization?
lolife you wrote: “Markets are great at some things but they have to be things that function well in an environment of greed. I would put schools and health care in the same boat, where the public good has to be the guiding principle, versus the good of the winners and the sorrow of the losers. In markets, some people lose. We can’t afford that in education and I think it is immoral, in this day and age, in this country, that we’d have losers on the health care side.”
In these words you show that you have conflated these two separable issues into one dichotomization of “market mechanisms or not” for both funding and delivery, but they need not be coupled. micadelic raised the very relevant example of such a separation his example of school vouchers as a way to have market forces on the delivery side of a subsidized service, education. I would be interested in hearing if you object to this idea, lolife, and if so, why. Please respond.
I think a similar model could be made to work for health care, although there the problem is made more difficult by the inelastic nature of demand: the number of heart transplants needed does not vary much as we change the price. There is a further difficulty caused by scarcity of supply for certain specialties, and raw materials, like organs and blood, and the difficulty of implementing competition in some cases: it is hard, as I lie unconscious in the ambulance, to direct the driver to my hospital of my choice!
But these are not problems without reasonable tradeoffs in a market-based system, and the costs and inefficiencies they introduce may well (and are likely, I assert) to be smaller than the alternative of a “fully socialized delivery system”. I am living it, guys, here in Canada, and it killed my father-in-law, quite literally. We are not allowed to buy our health care here, even if it would offload the publicly-funded system, and we could afford it. He died waiting for a bypass operation, because he didn’t want to travel to the ‘States to get it done.
We have at LEAST a two-tiered system here in Canada, and people who either believe we don’t, or who try to enforce a “single, socialized system” are living in denial. Mostly the system here works based on who you know, and how much influence you have, to get you to the front of the waiting lists. Though intended, I think the poor are hardly the beneficiaries of such a system in actual operation, as it is the rich and well-connected who get served first, and get the premium care, for “free” while the poor wait, and die. I have witnessed this, and cried with their families, while waiting.
My youngest son would not have survived without 3 months of neo-natal intensive care at birth, which, fortunately, we got, as denying him that care would have been a death sentence executed within minutes, and the Canadian system actually almost works for the most urgent of critical care. But much lower-cost preventative care, or lower-urgency care? It sucks. Please believe that I have much much more direct, personal experience with highly socialized medical care than I would prefer, and than either of you two, if you are both Americans.
A competitive market for health care delivery could be a very good thing indeed, if we are worried about cost and quality for the services delivered. I think lolife you will grant that if good and bad hospitals, doctors, etc had to actually compete in a market for their share of individuals’ “public health-care dollar” then it is quite likely that bad doctors and hospitals would be “weeded out” by the market and higher quality and more efficient doctors and hospitals would survive, thrive, and save lives. This would be good, in my opinion. Do you agree? Please respond.
To claim that we have fully explored market mechanisms in health care, and therefore have provable grounds for dismissing all possible market mechanisms in the health care sector is absurd, lolife. The peculiar nature of the market, as I point out above, most likely means that some regulation would be required.
It is funny to hear you use the “family as micro-communism” example, lolife, as I say EXACTLY the same thing. Literally. But I never fail to follow up with “But size matters”. What is good for my family, and in private policy, is not necessarily good for public policy, which is implemented by a third party, under threat of incarceration if one does not support the common good (ie pay one’s taxes).
I have granted that some public health care funding is a net social good, but how we will determine how much, who gets subsidized etc (still waiting for you to get back on this on the “Rossiter thread”, lolife) still has to be decided. I think it is important to consider a very valid train of thought, as follows.
Suppose there is a certain level of funding, such that every person could get a “free” innoculation, “free” care for communicable diseases, etc, and thus the basic social good of “Universal health care” as I described at the beginning is paid for, but no more. No casts for broken legs, no bypass operations, unless you have insurance, or can pay directly. Well, charities exist, thank goodness, so we can expect some of the additional demand will be paid for out of charity.
Now how much further must we go? And here comes the important part, where we will get to the Conflict of Visions, I am quite sure: for a government to go further than this, there is an implicit assumption that the level of charity in the society is somehow “insufficient”, ie the individuals comprising society cannot be entrusted with their own decision of how much they should keep themselves, and how much they should give to others, that the others will not suffer.
And right after this, we hit my “law of unintended consequences”. In Canada we have already created an uncharitable nation, or perhaps more correctly a nation of “charity through compulsion” as the government seems very willing to charitably support all kinds of people I would not, but if I choose not to pay that portion of my taxes, I go to jail. America remains significantly more charitable, measured by the metric of percentage of personal income donated to charities.
Finally, and to bring it back to the start, lolife wrote: “We should not socialize medicine. We should absolutely socialize health insurance.” I will agree with you, if what you mean is that the poor should be able to get at least enough insurance premium subsidy that they can buy the lowest level of insurance from private industry, ie that which is just sufficient to guard the general public against their ill health. Beyond that still requires debate, for me. I think you probably mean more, but were not specific enough to understand your meaning exactly.
I’ll stop here, but I hope that is a little bit of food for thought for both of you.
thanks,
b2b
PS: just as a reminder to myself, I still need to address the locus of risk-taking and the nature of insurance, the effects of cost-at-a-distance, biased consumption of public resources…
21 March 2008 @ 5:18 pm
Interesting discussion…
First, the left/right dichotomy is false, misleading, and useless. Identifying with the left or right is usually just a mental crutch. Even worse is arguing against a vaguely defined group of enemies (“You guys seem to think…”).
Both of you make valid points. One thing not mentioned is risk pooling. One limitation of the free market is that insurance companies will set a customer’s premium based on his level of health, or potentially just deny him coverage altogether. This makes coverage inaccessible for those most in need. I have wondered if it would be best to simply prohibit insurance companies from setting premiums based on a customer’s level of health. That way, healthy customers would effectively subsidize the unhealthy (or, in many cases, the unlucky).
In 2004, the American College of Physicians published an interesting white paper that analyzes the social costs of the uninsured (“The Cost of Lack of Health Insurance“)
I recently blogged about this paper when I discovered it. The conclusion of the paper was a positive benefit/cost ratio:
An interesting related note is that the High/Scope Perry Preschool Program similarly found a positive benefit/cost ratio for putting “high-risk” children through preschool in their Age-40 Followup study.