*Where* is US health care so darn expensive?

[Abegweit]

Every system has rationing. That's not possible to avoid.

What nonsense. You repeatedly invent stuff out of nowhere. The free market does not ration. If needs are greater than current production, then supply will increase in response. This is basic economics.

The question is whether they are effective, rational, and moral rationing. The US system would rather give a dying man an extra month of life than a child a lifetime. That's none of the above.

That's simply because it is run by government. And, of course, you defend Medicare even as you denounce its effects.

 

[Arwon]

Uh. Rationing is in this instance just an emotive term for the allocation of scarce resources. Markets are a mechanism which allocate scarce resources.

 

[Abegweit]

Uh. Rationing is in this instance just an emotive term for the allocation of scarce resources. Markets are a mechanism which allocate scarce resources.

Indeed. Unlike governments they allocate them to the people who have the most need instead of the ones who have the most political power.

 

[Arwon]

Absent a universal healthcare system, where exactly does a low-income earner get the cash to obtain highly demanded medical care, and to outbid others when demand pushes prices up?

Also where do you get the idea that our healthcare systems only allocate resources to "the ones who have the most political power"? What does that even mean? The entire point of the public health system is ensuring universal availability not just availability based on ability to pay. If I need to see a doctor or get a treatment, even if I have no money, I can.

 

[kochman]

Every system has rationing. That's not possible to avoid. The question is whether they are effective, rational, and moral rationing. The US system would rather give a dying man an extra month of life than a child a lifetime. That's none of the above.

And, you would have the government make that decision about your grandfather, for example?

 

[Arwon]

It's cute how you think that's a thing.

 

[kochman]

It's cute how you think that's a thing.

That was his example... so, I guess you think it's cute how he thinks that's a thing.

I never suggested that is how it operates.

 

[Cutlass]

And, you would have the government make that decision about your grandfather, for example?

You mean would I want the government to choose one extra month for my grandfather or a life cut short for my child? Let's put these things into context.

 

[kochman]

You mean would I want the government to choose one extra month for my grandfather or a life cut short for my child? Let's put these things into context.

No, you can't just act like the circumstances are defined by you, because we are talking about UHC...

In the situation you suggest, it could be ANYONE who is elderly, and anyone who is a child.

So, the child could be yours, and an unknown eldery person... in which case, I imagine you would support the government choosing your child over the unknown elderly person...

However, the elderly person could be your granddad, and the child an unknown to you...

So, given that situation, would you support the government saying it's time to go for old grandpa? Because, in a UHC situation, with rationing (good you acknowledged rationing, and I agree, which is currently based on $$$ rather than age), this is the reality.

 

[Cutlass]

The reality is that it makes no difference who's granddad and who's child it is. There is going to be a limit on what is spent. There is going to be rationing. There is going to be people who do not get the care that they might get. And there is going to be people who die sooner than they might otherwise have died as a result.

You cannot change any of those facts.

So given that, what is the moral and ethical way to choose? What is the cost effective way to choose? What is the rational way to choose?

The current US system is not moral, ethical, effective, or rational. It's beaten on those criteria by every UHC in the developed and near-developed world. And yet we spend vastly more money to get far worse overall results then they get. It is unsustainable. The country cannot afford it. It is going to impoverish us, and many people will die as a result.

There are already 50,000 Americans a year dying prematurely because of lack of access to medical care. We change the system, or that number grows.

 

[GoodSarmatian]

And, you would have the government make that decision about your grandfather, for example?

Why should I trust my elected and theoretically accountable government more than a profit oriented insurance company that I have no stake in ?

By the way, my 70 years old father had surgery last year. No rationing here.

 

[kochman]

The reality is that it makes no difference who's granddad and who's child it is.

Well, you did just try to frame it that why.

So, I guess you are backing down from that framing...
You can say it makes no difference, but to the families involved, it most certainly does. That's why people get upset... you see?

So given that, what is the moral and ethical way to choose? What is the cost effective way to choose? What is the rational way to choose?

So, you are more or less saying, you believe in the government choosing?

Why should I trust my elected and theoretically accountable government more than a profit oriented insurance company that I have no stake in ?

By the way, my 70 years old father had surgery last year. No rationing here.

I'm not saying you should... nor did I say there was rationing... I was simply questioning Cutlass using the 1st obvious questions that come to mind.

For the record, my experience under UHC in Germany, when I lived there, was pretty great... way better than the somewhat UHC I experienced as a member of the military and a military dependent as a child, in the USA.

 

[luiz]

Every system has rationing. That's not possible to avoid. The question is whether they are effective, rational, and moral rationing. The US system would rather give a dying man an extra month of life than a child a lifetime. That's none of the above.

The same can be said about our public universal system. In a country where millions of kids grow up without access to treated water, and thus may die prematurely of all sorts of diseases, some individual patients cost the health system millions of dollars every year.

That's poor allocation of public resources, evidently.

 

[Cutlass]

Well, you did just try to frame it that why.

So, I guess you are backing down from that framing...
You can say it makes no difference, but to the families involved, it most certainly does. That's why people get upset... you see?


So, you are more or less saying, you believe in the government choosing?

Someone has to. The private sector isn't doing it. I'm not talking about "death panels". I'm talking about a budget that makes priorities on what will do the most good.

The same can be said about our public universal system. In a country where millions of kids grow up without access to treated water, and thus may die prematurely of all sorts of diseases, some individual patients cost the health system millions of dollars every year.

That's poor allocation of public resources, evidently.

The fact that your country has not worked out how to make some of these choices well is not an indictment of UHC in either concept or execution. You're still doing better than the private sector health care.

 

[Abegweit]

The entire point of the public health system is ensuring universal availability not just availability based on ability to pay.

Such a pretty fantasy. Unfortunately, it is wrong. The purpose of the state is to enable the politically powerful to steal from the politically powerless. BTW, we live in a world of limited resources. "Universal availability" is just another fantasy put forward by ******s who have no notion about how the world actually turns.

Moderator Action: Flaming other members will be neither welcome nor tolerated in here - Grisu
Please read the forum rules: http://forums.civfanatics.com/showthread.php?t=422889

 

[kochman]

Someone has to. The private sector isn't doing it. I'm not talking about "death panels". I'm talking about a budget that makes priorities on what will do the most good.

Here's the thing... neither way is perfect... I grant this.
I feel more optomistic with the current way... though it is not "fair".

In the current system, more people can afford to spend the extra money to buy better HC...

In the UHC system, and the accompanying higher taxes, you effectively take more people out of that "can afford" bracket... because private insurance will be a luxury few can afford...

So, in the current system, companies decide, to an extent... but private citizens have some power to override that through their own financing.

In a UHC, the government decides (and remember the US Gov could screw up a wet dream)... end of story.

Things like this make me wish my people had never left Europe.

 

[Cutlass]

And yet UHC cost from a low of 1/2 what we have to a high of not more than 2/3 of what we pay. And we get less coverage. So the "costs in taxes" argument is complete bullpoop. No matter what we are paying a lot less for UHC and getting more coverage. So you are not taking more people out of "can afford", you are taking more people out of "can not afford".

 

[kochman]

And yet UHC cost from a low of 1/2 what we have to a high of not more than 2/3 of what we pay.

Source?
How the heck can you know that, if it hasn't been implimented. You really trust the math? I don't.

No matter what we are paying a lot less for UHC and getting more coverage.

Seriously, this type of claim needs to be supported by fact... not just statements on the internets.

 

[Cutlass]

In every UHC system in the world the costs is 1/2 to 2/3 what the US spends, and in 36 countries the outcomes are better than the US outcome. So the burden of proof against UHC has to be on those who think the US cannot do as well as Cuba for whatever reason.

 

[Tahuti]

Why should I trust my elected and theoretically accountable government more than a profit oriented insurance company that I have no stake in ?

I know your post is sarcastic in intention, but on the serious note, do note that governments are often catch-all affairs, meaning that peoples votes on matters of national security, justice and welfare can often affect governments' judgements on health care as well (party-politics and all), though that problem could be rectified by having governments delegating health-care to organs jointly governed by patient-advocacy groups and health-care sector employees.