Socialized Healthcare

[DemonicAppleGuY]

And if you can afford to pay what it would cost to run the system (and subsidize those who can't while anyone with money is not part of the system) you will likely be paying into the private system, not the government one. By eliminating everyone in the middle class upwards from the funding pool you aren't going to have much coming in.

Could you rephrase that...?

It would not subsidize those who could not afford it. It would simply be a government run alternative to private insurance companies. Because of its (proposed) non-profit nature and the number of clients it would have, it would be far cheaper than any private insurance company. So most middle class consumers would happily go for it.

 

[say1988]

Could you rephrase that...?

It would not subsidize those who could not afford it. It would simply be a government run alternative to private insurance companies. Because of its (proposed) non-profit nature and the number of clients it would have, it would be far cheaper than any private insurance company. So most middle class consumers would happily go for it.

It would have to subsidize everyone who can't afford insurance. There will be a lot of people in the system paying far less than their cost of the system (if anything). And will also feature a larger proportion of the elderly living on fixed incomes with far greater health costs. Plus, for various reasons, the poor are, on average, less healthy than the wealthier people.

Such a system is effectively going to force the lower middle class to pay for the healthcare of the lower class.

This will likely result in a lower tier of healthcare due to a lack of funding and anyone who can afford it moves to the private system and it just gets worse.

The whole point of this type of system is those who can afford healthcare subsidize it for the rest. Any subsidized healthcare for the poor with have to have the upper segments of society paying into it somehow.

 

[DemonicAppleGuY]

It would have to subsidize everyone who can't afford insurance.

Why?

This isn't about funding for the poor. This is about creating a health insurance program that is cheaper. Making it non-profit and having it have more customers than any other private insurance company is one of the ways.

 

[MagisterCultuum]

I am not a fan of socialized healthcare systems, but I'll freely admit that they are often much better than the hybrid system the United States has. It is completely disingenuous to present the US system as if it were an example of an unfettered free market. It may make sense to move towards a more socialized system than to keep things as they are, just as it is better to cross to the wrong side of the tracks rather than stand still while a train is speeding towards you.


I'd prefer a more free market solution, which would require eliminating market interventions like agricultural subsidies (which encourage unhealthy diets that contribute to many diseases), patents, (re-)importation bans, tax breaks for employer provided health insurance, etc.

I might also have some legislation requiring that medical facilities make their prices known to the public and consider not allowing them to charge the uninsured more than they charge insurance companies. Currently the price differences for many non-emergency procedures often differ by hundreds of thousands of dollars even between hospitals that are only a couple of miles away. Since almost no one pays the official price, the incentive is to make the price high enough to make insurance companies think they are getting a good deal even when they are being fleeced. They are not effected much by market forces, and customers cannot really shop around.

If I remember correctly, most health insurance was provided by non-profit companies and mutual aid societies around the turn of the last century. This is what the free market preferred before government incentives (and some actions by the American Medical Association) encouraged the big businesses to take over. When FDR capped wages, giving extra benefits like health insurance became the only legal way to give raises. Later tax breaks encouraged employer provided health insurance, which made it even harder to get good deals on individual plans.

Yeah, I think that about sums up both sides of the argument.

What do you guys think of a state-run non-profit insurance company that citizens could buy into?

I think this would be far easier politically to create because people are still paying for it. Since it would cover many people (and is non-profit) it would be far cheaper than any other insurance plan, many more Americans could afford it.

This could transition sometime into universal healthcare, but that would take a lot more political will I reckon.

Even more politically impossible. An "NHI" alongside private companies would surely drive private companies out of business over time though.


Unless the public side is funded by voluntary insurance payments rather than compulsory taxes.

How would this be any different than a private non-profit insurance company? Unless it is granted some monopoly status or other subsidies funded ultimately by those who would not choose to use this institution's services, I see no difference.

 

[DemonicAppleGuY]

How would this be any different than a private non-profit insurance company? Unless it is granted some monopoly status or other subsidies funded ultimately by those who would not choose to use this institution's services, I see no difference.

Mainly the granted monopoly status.

A private non-profit could work too I guess. It'd have a hard time getting up on its feet though I think.

 

[say1988]

Why?

This isn't about funding for the poor. This is about creating a health insurance program that is cheaper. Making it non-profit and having it have more customers than any other private insurance company is one of the ways.

So what about healthcare for the poor? Are you expecting them to die in the streets? If not, then you need to subsidize their care.

 

[MagisterCultuum]

What the poor lack is not simply healthcare, but money.

Rather than allocating funds to their healthcare, it would be better to provide them a basic income guarantee (or a citizen's dividend funded by land value taxes, as I'd prefer).

Health insurance is a usually much lower priority than basic food and shelter.

 

[say1988]

What the poor lack is not simply healthcare, but money.

Rather than allocating funds to their healthcare, it would be better to provide them a basic income guarantee (or a citizen's dividend funded by land value taxes, as I'd prefer).

Health insurance is a usually much lower priority than basic food and shelter.

It is a lower priority because when you are living from paycheque to paycheque you can't consider the future. It is also extremely costly for society if a significant number of people can't recieve regular medical attention.

And you are just quibbling over the route to subsidize, not the act.

 

[shadowplay]

Works okay for most things. Specialists, not so much. Hope you have money in the bank for a trip to the States.

 

[tonberry]

"Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance – where, in short, we deal with genuinely insurable risks – the case for the state's helping to organize a comprehensive system of social insurance is very strong.... Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make the provision for the consequences, such communal action should undoubtedly be taken."

That's from The Road to Serfdom by Friedrich Hayek. Even the most ardent defender of free market do make exceptions when it come to healthcare (among others things).

 

[DemonicAppleGuY]

So what about healthcare for the poor? Are you expecting them to die in the streets? If not, then you need to subsidize their care.

Mostly just die in the streets at the start. This hypothetical "NHI" would lay the groundwork for universal healthcare at a later date. Theoretically the NHI being cheaper would also give many more people the opportunity to get healthcare that currently cannot afford it.

 

[Tahuti]

I would leave the health care providers privately owned and operated, although I would prefer they be non-profit. I'm only talking about making health insurance publicly owned.

For-profit health insurance providers are evil, but government tends to be really slow to change. For instance, in the hybrid public-private health care system of the Netherlands, government can dictate what private insurers should reimburse and what not, and useful new treatments are often left out. Perhaps cooperatively operated insurers funded by government.

I don't really see how the nature of health insurance has any influence on medical innovation and I don't see how there's a trade off. I really can not think of any advantage of the american moel.
It is of course a matter of implementation. I think my country's healtchcare policy is decent, but that's about it. There are some serious flaws that need to be ironed out and I'd much rather prefer something like the NHS.

Well, the American model should never be adopted, and America itself should get rid of it ASAP. America may have the most privatised healthcare system in the world, but unlike Europe, the little government intervention there is in the American health care system is overwhelmingly negative (i.e. numeris fixus on medicine students and medicare, which all cause medical inflation). However, the fundamentally private nature of the makes the American health care system more responsive than most European health care systems, both technically and in terms of waiting lists. That's a good thing, and should be conserved.

 

[Traitorfish]

I honestly think it's a great idea.

I thought you were a realist?

 

[DemonicAppleGuY]

I thought you were a realist?

What's your point?

 

[Traitorfish]

What's your point?

Realists are supposed to look at politics in terms of power and necessity, not in terms of "good ideas".

But, most vulgar realists turn out to be realists only insofar as it applies to others (dismissing their ideas and/or slaughtering them), and thorough idealist when it comes to themselves, so I'm not entirely surprised.

 

[DemonicAppleGuY]

Realists are supposed to look at politics in terms of power and necessity, not in terms of "good ideas".

My reasoning behind the "good" in "good idea" is that by decreasing the cost of healthcare it could increase the strength of the United States by bettering its economy.

As I stated already, the poor can still die in the streets.

 

[Traitorfish]

Yes, yes, we've established that you have a lump of coal for a heart.

The point is that for a realist, national is not made by "good ideas" any more than international diplomacy. It's the result of conflicting interests, and the most effective solution is not that which meets some fanciful idealist's conception of "economic efficiency", but which offers a plausible compromise between contending interests. For the realist, socialised healthcare is neither a "good idea" nor a "bad idea", nor could such things exist outside of the perspectives of specific interests, but rather it must be understood as the outcome of an (ongoing) multi-dimensional power-struggle within society.

 

[DemonicAppleGuY]

Yes, yes, we've established that you have a lump of coal for a heart.

The point is that for a realist, national is not made by "good ideas" any more than international diplomacy. It's the result of conflicting interests, and the most effective solution is not that which meets some fanciful idealist's conception of "economic efficiency", but which offers a plausible compromise between contending interests. For the realist, socialised healthcare is neither a "good idea" nor a "bad idea", nor could such things exist outside of the perspectives of specific interests, but rather it must be understood as the outcome of an (ongoing) multi-dimensional power-struggle within society.

Ah I see what you're getting at. Well I'm also a nationalist. And making the US stronger is just a good thing you know?

 

[Traitorfish]

You're bad at political theory, is what you are.

 

[Kennigit]

never heard of it