Universal Health Care - Page 10

Kaj · #91 08-08-2007, 07:55 PM

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Universal Health Care...Three little words that keep popping up. Sounds great... right? After all its free...right? Hey sign me up!
But the real story is that it is a bad idea. Bottom line Universal Health Care= higher taxes. But don`t take my word for it. Ask those who live with it, like the nation of Norway.
The goverment ( Norway ) is giving you free health care, or at least that is what they say. But that means you are paying for it with your tax dollars. Norwegians are some of the most heavily taxed people in the world. That makes Norway one of the most expensive countries in the world to live in.
In Norway a glass of cheap wine costs ( in U.S. dollars) 16 dollars, gas costs 9 dollars a gallon, and the tax on a new car doubles the price of that car.
Remember free health care is a bitter pill to swallow. Would you rather spend 20 dollars co-pay on a doctors visit or an extra 20 grand or more on a new car?
Its your choice.

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Nobody thinks its free. Guess what? Our Army, Navy, AF, Park Service, Schools, Fire Depts, FBI, etc., aren't free either. So until you start railing against "universal national defense" with equal passion, then your argument is selectively applied (i.e., hypocritical).

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This is like saying anyone who opposes Stalin or Hitler and doesn't oppose Lincoln or FDR with equal passion is hypocritical. Personally, I oppose all 4, but Hitler was definitely worse than FDR.

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Since the only argument he used in his OP was that it would mean higher taxes, universal health care isn't worse than those other programs. So, I respectfully disagree with your take on my take.

Kaj · #92 08-08-2007, 07:57 PM

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Universal Health Care...Three little words that keep popping up. Sounds great... right? After all its free...right? Hey sign me up!
But the real story is that it is a bad idea. Bottom line Universal Health Care= higher taxes. But don`t take my word for it. Ask those who live with it, like the nation of Norway.
The goverment ( Norway ) is giving you free health care, or at least that is what they say. But that means you are paying for it with your tax dollars. Norwegians are some of the most heavily taxed people in the world. That makes Norway one of the most expensive countries in the world to live in.
In Norway a glass of cheap wine costs ( in U.S. dollars) 16 dollars, gas costs 9 dollars a gallon, and the tax on a new car doubles the price of that car.
Remember free health care is a bitter pill to swallow. Would you rather spend 20 dollars co-pay on a doctors visit or an extra 20 grand or more on a new car?
Its your choice.

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Nobody thinks its free. Guess what? Our Army, Navy, AF, Park Service, Schools, Fire Depts, FBI, etc., aren't free either. So until you start railing against "universal national defense" with equal passion, then your argument is selectively applied (i.e., hypocritical).

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Because government corrects for the collective action problem. People have personal incentives to cover themselves in the most efficeint way, but people do not have the incentives to build roads or join an army. Its not hypocritical at all to realize that we need some government without expanding every facet of government.

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See my post above to Alex.

The only take in this OP is that UHC is bad because it means taxes. Well, every govt program means taxes. And I don't recall the OP complaining about any other govt program. If he wants to make a logicval argument or utilitarian argument against UHC, fine... but his OP wasn't in that ball park.

Copernicus · #93 08-08-2007, 08:04 PM

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not all medical problems (in fact the majority of them) are not fatal, but affect the quality of life. there is no such "certainty" of reflection in mortality rates

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well, then there is considerable debate as to whether or not they are needs. Beyond that, I would imagine that if the methodology of these studies overlooks people who were unable to get a surgery, they likely also overlook people whose insurance policy didnt cover a surgery. How these two groups compare, I cannot say.
 sorry, I really dont understand your point here 

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wow. Youve missed a lot here

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only if I were to assume that

1) he would have insurance if he lived in the US there is already as close to universal availability of coverage as can ever be accomplished. Whether the individual avails himself of that coverage is up to him. 
2) his insurance would cover part/all of the surgery coverages for necessary surgery in the US are essentially all inclusive
3) he could afford to pay whatever costs insurance didnt cover again that is pretty much voluntary. policies with surgical co-pays and deductibles that are extremely low are available. If you elect catastrophic coverage only with deductibles you cant afford, that was your own fault for trying to save $50-$100 a month in premiums. 

I only "missed something" if I dont make all 3 of those assumptions.

Whether or not that set of assumptions is good or bade to make isnt something about which Im certain. so yes, they are good assumptions for all but the indigent, who legally cannot be denied medical care for inability to pay

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actually, it is very representative of the underlying population. Can you spend more and get better care? Obviously "surgeons to the wealthy" got there by providing something of perceived value for their money. Whether or not that was a better outcome or just a nicer room is open to debate. What isnt open to debate is that the standards of care in the US are relatively uniform. Educational and experience requirements are diligently adhered to by US hospitals, whether they cater to the elite, or are an inner city clinic. The less competent very quickly find themselves unable to get malpractice insurance, even if they manage to keep their licenses.

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Well, its certainly not representative of the population that doesnt have insurance, or for whom certain treatments are not covered by insurance. covered above 

Beyond that, other people in the thread seemed to believe that the high cost of US heath care could be party explained by large amounts payed for great care, by the top of the population.

Evidently you disagree. i dont disagree that it is a contributor to relatively high costs. I think a greater contributor is the more open access and high technology approaches to medicine that may not find its way to outcomes, but are less invasive, less painful, entail less recovery time etc. 

Why then, is the US so far above others in cost, while still lagging behind. Or, do you believe the US does, in fact, provide the best health care in the world, and any study that claims otherwise is false?

[/ QUOTE ] I don't like expressing things as absolutes. It is ONE of the most expensive, and provides health care among the best in the world. There arent enough valid statistics to differentiate among the highest n in costs, or the top k in quality. The US is clearly in both of those (limited) groups.

superleeds · #94 08-08-2007, 10:42 PM

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"It seems reasonable to suspect that government might be able to administer some particular industry better than private business due to differences of structure and incentive."

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It may seem reasonable... but can you give us an example?

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The fire service

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Just because you say so?

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No. Simply because it doesn't happen. I can't think of any security issues and yet private companies don't seem to be too interested. I'm sure governments would be willing to entertain any serious proposals. I suspect they get few if any.

vhawk01 · #95 08-09-2007, 01:17 AM

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"It seems reasonable to suspect that government might be able to administer some particular industry better than private business due to differences of structure and incentive."

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It may seem reasonable... but can you give us an example?

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The fire service

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Just because you say so?

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Are there laws restricting competition from private fire companies?

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Speeding, red lights, stop signs, and no parking in fire zones come to mind as laws which might hinder a private service.

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No, TAXES come to mind.

vhawk01 · #96 08-09-2007, 01:20 AM

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Editted to remove pointless snarky comment.

So the United States, in aggregate, spends more dollars per capita on health care? So what?

I notice the graph shows dollars spent on health care per capita, rather than the fraction of per capita production spent on health care. Adjusting for this produces a number that is much more in line with the nearest countries, although US spending is still the highest at about 11%, with the nearest other country being germany at 9%. Hence total US health care spending is only of order 20-25% higher than Germany, rather than the misleading 50% above the nearest country (Switzerland) indicated by the original graph.

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No matter how you try to slice it, the US spends WAYYYY more on health care (for worse results).

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But even this number is deceptive. It is an elementary thought experiment to decide what the implications of this logic is: If a government wants to spend it's countries health care dollars more "efficiently", all it has to do is nationalize the health care system, and then not spend anything on health care at all. What an astonishingly low sum to spend on health care! Surely such a health care system is a marvel to be emulated. Any country can look more "efficient" under this criteria by simply spending less on the health care of their citizens.

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This is just silly. We would be fine with the US spending tons tons more on healthcare if the US healthcare system yielded better results. It is appalling that we spend this much and end up getting worse care on average.

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This is most blatantly the case in the UK, where the socialized health care system is an ongoing national unnatural disaster of shortages, wait lists, rationing, and simple non-treatment.

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And they still manage better results than the US freeish market system. (mostly because the waitlists etc are on nonessential surgeries.

One of the best single indicators of a countrys health was developed by the WHO; called "healthy life expectancy." This measure represents the number of years that a child born now can expect to live in good health (i.e; total life expectancy minus years of illness adjusted for quality of life). This is good for the US because we get elective procedures done quickly. By this measure the a child born in the US today can expect to live the equivalent of about 69.3 healthy years of life, while children born in the other 22 industralized nations can expect an average 2.5 additional years ("overdosed amercia" by john abramson or search around and find the WHO study) .

Every way we try to slice the data, the US healthcare system just does not preform very well.

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Americans can spend a higher fraction of their income on health care because health care is largely a luxury good. As real income increases relative to higher priority goods like food, clothing, shelter, energy, etc., more "discretionary" income is available for less critical things like entertainment and healthcare. America with it's high per capita average income will have of course see a higher than average fraction of that income dedicated to these things. Should we conclude that our theater industry is "inefficient" because American's spend a much high fraction of their income on movies than any other country in the world?

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Yeah, and there is 1 thing that all the extra money we spend on health care is buying us. (this where it starts to click together.)

The US provides the best SERVICE to patients in the world. A WHO study that evaluated seven nonmedical aspects of health care like prompt attnetion, quality of amenities, autonomy, confidentiality etc the us was a clear 1st place.

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Furthermore, these kinds of international comparisons are useless in the absence of incredibly high end regression analysis with a tremendous amount of data, since they violate ceteris paribus, i.e. all else is not equal. Even in that case the results are always open to interpretation. Americans are the fattest people in the world, as everyone likes to tell us. We voluntarily choose to be so, but the cost is in poorer average health, poorer average health that must be paid for by increased health care spending, so we spend more.

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Contrary to common wisdom, the poor ranking of the US cannot be attributed to our rates of smoking, drinking, or consumtion of red meat. America ranks in the better have of industralized nations on those measures, and we have the 3rd lowest cholesterol.

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Altogether I am reminded of the ridiculous claims that health care is better in Cuba in the United States because infant mortality is lower, without regard to the fact that neonatal care in the United States is so superior that high-risk pregnancies that simply become miscarriages in other countries become premature births in the United States, thus leading to elevated infant mortality rates.

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The US ranks a lowly 24 among 39 developed countries on infant mortality. There is, however, a problem with international comparisons of infant mortality. Resuscitation is more likely to be attempted on extremely premature babies on in the US than many other countries. The extremely premature babies on whom resuscitation is unsuccessful are then counted as infant deaths, whereas they would be counted as fetal deathes if no attempt at resuscitation had been made. A way around this problem is to look at mortality rates after only a week of life. On that measure the US position improves only from 24 to 20.

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Lastly, I find it laughable that the authors of the study neglect to tell us that the reasons that healthcare goods and services and administrative costs are rising so fast is because of the cost of regulatory compliance and administration imposed by government, a large part of which non-profit and government run hospitals are exempted from.

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And the non-profit hotpitals are doing no better than their for profit brothers.

The rest of your post looks like general free market is better than goverment stuff (which I agree with for the most part.)

The problem with the health care system is not that the free market is broken. It isn't even goverment intervention. I believe that goverment intervention has raised the cost of health care to some degree, but not nearly enough to cause this "crisis." To be honest, "administrative costs and the cost of regulatory compliance" aren't a big deal when compared with the more dramatic things goverment has done (wage control + tax breaks for health insurance causing employers to be the primary gateway for people to become insured.)

Anyway, I got off topic. The goverment hasn't helped, but the goverment isn't the problem. The consumers are the problem. The free market is reacting to consumer demands. The consumers don't demand better healthcare (they don't know what better helathcare is in the firstplace). Consumers often identify more treatment with better treatment. Consumers want nicer hosptial rooms and to be treated better. The consumer wants the newest arthritis medication they saw on tv (despite the fact that it is no better than the old one that costs 1/10th the price) So, the consumer gets these things.

The money doesn't go toward education the public on what makes them healtheir, the money goes towards making them believe vioxx is the answer. So, people demand that their insurace company give them vioxx or they'll change insurance companies.

So, do we need daddy to come in and tell us what is best for us? Do we want daddy to make healthcare cheaper and more effecient? Oy vey, i wish we (consumers) could as a group see the long term. It would make things easier.

If you want any of my sources, let me know.

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We do not get worse care (as far as I know) we are less healthy. This is a HUGE difference, as any physician will tell you.

The Truth · #97 08-09-2007, 06:28 AM

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Until you can understand that these sorts of comparisons between things that are not otherwise equal are worse than meaningless, they are outright intentionally deceptive

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However, isn't it useful to try to develop aggregate comparisons that are meaningful? In other words, if you can account for differences in the population to come up with apples-to-apples health care aggregate expenditure costs wouldn't that be useful information? Particularly when one is trying to debunk "ends justifies the means" arguments. If you can show that the "ends" aren't even better, then you don't even have to argue that the means are evil.

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I've already said in the thread that correctly done studies can be useful for illustrating economic theory. But they are very hard to do, take an immense quantity of data, have to be extremely carefully analysed, and even then cannot actually trump theory.

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I agree. There are so many variables related to these kinds of studies, biased researchers have lots of room to spin the data. (leaving out homocide/accidental death rates of each country when calculating life spans is one glaring example I have seen repeated numerous times)

mrick · #98 08-09-2007, 10:27 AM

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Infant mortality is higher in the US than many industrialized nations. Why? Because the profile of the population giving birth in the US has much higher incidence of risk factors...younger women, older women, and welfare mothers.

[/ QUOTE ] I cant belíeve that the average American woman giving birth faces worse circumstances in general than the average woman giving birth in the third world or the rest of the industrialized world under most kinds of measurement. Welfare for example is more prevalent in other industrialized nations than the US.

If what your saying is actually the case then the american economys champion vigor means very little. Which is it?

Copernicus · #99 08-09-2007, 11:53 AM

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Infant mortality is higher in the US than many industrialized nations. Why? Because the profile of the population giving birth in the US has much higher incidence of risk factors...younger women, older women, and welfare mothers.

[/ QUOTE ] I cant belíeve that the average American woman giving birth faces worse circumstances in general than the average woman giving birth in the third world or the rest of the industrialized world under most kinds of measurement. Welfare for example is more prevalent in other industrialized nations than the US.

If what your saying is actually the case then the american economys champion vigor means very little. Which is it?

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First, the comparisons being made here arent to third world countries, so throw them out of your question. They fall way behind in virtually all statistics.

And yes, the actual percentage of high risk pregancies that make it to birth is higher in the US that other industrialized countries. Thats a combination of several factors, the most important being relatively more high risk women getting pregnant to start with, better pre-natal care so more at risk preganancies actual make it to birth, and better premature birth facilities so more attempts are made to achieve births that would be abandoned in other countries.

Why do more at risk women become pregnant here in the first place? Teen pregancies are among the highest in the industrialized world especially among lower income groups. While overall birth rates in the US have been stable or gone down, they have gone up in the lower socio-economic classes where the risk of low and very low birth rates is much higher. There are financial incentives for the lowest socio-economic/highest risk births to become and remain pregant. At the other end of the spectrum older pregancies are more common because higher percentages of women delay pregancy for their careers, and the high divorce/remarriage rates lead to second families being started at a higher age.

Your "welfare" statement is misleading. Yes, there is more wealth transfer in many other industrialized nations. To the extent that those transfers raise the socio-economic status of the welfare recipients more effectively, that will tend to improve their birth rate statistics. However, the more important effect here is that women of low socio-economic status are essentially paid to become baby mills....the more they have the bigger their subsidies. That is not the case in most other systems. Also the rate of neglect is higher in those single parent welfare households.

I dont understand this conclusion at all, perhaps I just dont understand what you are saying: "If what your saying is actually the case then the american economys champion vigor means very little. Which is it? "

Why would a higher rate of at risk pregancies and one of the best health care systems be a black mark on the amercian economy's vigor?

CallMeIshmael · #**100** 08-09-2007, 01:55 PM

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sorry, I really dont understand your point here

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you said that the statistical reports dont reflect people who are not treated. However, the same can be said about people whose insurance doesnt cover treatments.

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coverages for necessary surgery in the US are essentially all inclusive

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Well, "essentially" is obviously a red flag here. And of course, you can assert this just as well as I can assert "all Canadians get access to necessary surgery"

But, I know a friend from school whose mother didnt get a surgery because it wasnt covered. (it wasnt a complete necessity, some back pain thing). Am I now to conclude that this isnt 'atypical'?

No, because I think its poor reasoning to judge complex situations based on a few anecdotes. But, I dont think you've presented any clear evidence to show that the problems of non-access in Canada are any more severe than they are in the US.

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It is ONE of the most expensive, and provides health care among the best in the world. There arent enough valid statistics to differentiate among the highest n in costs, or the top k in quality. The US is clearly in both of those (limited) groups.

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when you said "The countries that provide socialized health care are evidence that it isn't true, since they are either extremely expensive, lower quality or both" you seemed to find ways to do some rough rankings.

What countries have medical care that cost more than in the US, and yet is of poorer quality?