Re: OT they want to run your healthcare

da pickle wrote:
"Clave"

Name for us a "universal healthcare" system that does not involve the
state limiting how care is administered, rationed, etc.
If you can't even acknowledge that health insurance is not health care, why in the wide world of *** should I?

I will acknowledge that health insurance is not health care ... now, please explain for me how any "universal healthcare system" does not involve the state determining how health care is rationed?

The problem in the USA with the "health care" or "health insurance" crisis is exceptionally complex with multiple causes and unintended consequences. General and vague and uninformed comments form the basis of most of the posts ... which usually disintegrate into shouting matches ... because the participants have not agreed on common nomenclature and definitions.

The term "health insurance" is more misleading than the term "home insurance" but the circumstances are different and the problems are different. [For example, if someone has paid for a home and does not want to have "fire" coverage (or any number of "extended coverages" available on different policies) on that home, that person could lose their entire investment. For many, their home represents their entire net worth.] [I was watching the news yesterday about a different circumstance during the floods (Iowa?) and a man watched his home disappear in the swollen river. He has 23 years left on his mortgage to pay. Should the government pay for all such loses or should we all have mandatory "flood insurance" whether we "need it" or not?]

Probably not, but having your home damaged by flood, as unfortunate as it is, and coming down with a severe illness or injury are not the same and are not necessarily viewed or acted upon in the same way. There is an essential element of humanity that makes us vulnerable to sickness or injury, part of that same commonality is what responds when we act in solidarity against those threats.

[Why did the government pay all that money to people as a
result of the WTC bombing? Should we all pay for a "universal terrorist protection" policy to provide for such losses?]

I will acknowledge that in the USA, the term "health insurance" is almost a meaningless term when used in this debate. There is no one thing that can become "universal" when one is talking about "health insurance."

The term "universal coverage" is not intended to be taken literally. In fact, all life forms in the "universe" are not covered :) In Canada it means simply coverage which applies to all citizens equitably.

Countries develop their economies in different ways. The USA is pretty much alone among the "civilized" countries with a history of free market economic development.

That's certainly untrue. I don't know how you can say that.

We can argue forever about which parts started to move toward more and more state control. [I would start with "education" as a better model than "health care" for an example of a part that is almost completely under state control.]

But again, education and health are not the same thing and therefore not necessarily viewed in exactly the same way. People for example don't have car accidents and suddenly need a large input of education funding, people as they age do not require more and more educational interventions.


All medical care in most countries is almost completely controlled by the state.

That's misleading. My doctor is not "controlled by the state", he operates under a standardized fee schedule for the services he renders, but he is a private businessman with his own office, staff, his own hours and chooses who he will treat and when. Most important of all, he determines what treatment each patient requires, the "state" has no say in that. The insurance company he uses has no say in what his treatment should be. His education was also subsidized by the public. If he migrates to the US, he is taking that training with him that I paid for.

> Doctors and other health care worker do not make as much money as
they would make in the USA.

That's generally true of doctors, I'm not so sure its true of all "workers" within the system.

This may be a good thing or not depending on your view.

It's good for doctors, it attracts doctors, but its ultimately a cost paid by the public, so does it really make the most sense? A qualified doctor should make a specific diagnosis of a specific problem regardless of his fee. Yes the fee should be fair and adequate, but apart from broad ideological reasons, why does it need to be set by the doctor?

The question is whether having the state determine what a doctor will be paid for a specific item is an effective and efficient way of making this determination.

The "state" sounds so 'Stalinist', it is a board comprised of citizens, doctors, economists and professional administrators.

More and more countries are loosening the state control and "privatizing" certain aspects of their "health care" system. Such actions are an acknowledgement of the superiority of the "market" in allocating goods and services.

Not necessarily, since they are not moving totally to fee market access. In fact it shows what international studies reveal, that a certain combination of state and private is ideal. Too rigidly government is not ideal, too free enterprise is not ideal. A private/public balance has been achieved in several European countries which results in excellent care for everyone.

The term "privatization" has so many different meanings as to almost be as useless as "universal" as a description of whatever is intended by the reference.

Privatization basically means that the practitioners set up the clinic, buy the equipment, set the fee schedule and are paid directly by the patients or through private insurance, not through the government plan. Sometimes the government system uses those facilities and pays the clinic for that use, they become private clients.


The USA has moved toward more and more fragmented state control in the medical goods and services economy so as to make the discussion fruitless without details. There is no real "market" for "health care" in the USA.

How do you mean? There is always market for health care, always will be.


So, we find everyone screaming about the need for the wonderful (and illusionary) "universal health care" and putting up systems that they do not understand as the gold standard.

There are many different models, but the one thing is consistent to all of them except one, they offer medical care to every citizen, every old person, every child.


Like many other economies, the USA needs to move closer to a free market rather than continue to move toward complete state control. How to do this requires detailed discussion that likely beyond this forum.

That's not necessarily true in this instance. It may be so in education, if public education is not serving the public interest, but if the balance between free market and government in health care is weighted too heavily towards free market to serve the best interests of the public, e.g. it costs too much, is subject to abuse, serves as a disincentive to some to work at low paying jobs, causes too much financial hardship to too many, and leaves people vulnerable to devastating illness or injury, then the pendulum ought to swing the other way. There is plenty of objective evidence to support this view.


We can, however, have a useful discussion about whether state control is more effective and efficient than market control ... it would apply to each separate economy in slightly different ways, but the "general" discussion would be the same most of the time.

I disagree. It may be quite easy to reach the consensus that it is up to the individual whether or not to insure his home and for what threats, but not so when deciding to allow the individual to neglect to protect his medical insurance. And the reason is simple, if we do so ultimately you either end up caring for him anyway when he becomes financially bereft, or some manipulation of the system takes place, or he is left to suffer, all of which are unacceptable outcomes.


I favor free markets for almost all rationing ... surprise.

No surprise, such ideological devotion to "free enterprise" is at the same time America's strength and it's Achilles Heel. In the case of health care, there is no "free market", only the illusion of it. What exists in the US is a free market system with an expensive fragmented state system picking up the broken pieces of people's lives. The most successful models of health care have realized that it works for the betterment of most people to balance and integrate public and private interests deliberately and rationally not to allow one to dominate.


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