Mmmkay, dunno where all that came from. I was just agreeing with you that the government tends to come up with steaming heaps of compromise that achieve little more than screwing everyone equally.

Don't you ever read Joe User? That final paragraph is in response to the mortar and pestle of the offical canon of the site.

The thing is that bad as the government is, it's our only hope. The only other choices are to leave it to the free market or do nothing, which is to say our choices are to do nothing or to do nothing.

That's why my initial proposal was to pick a system and emulate it as opposed to letting the AMA, the health insurance industry, PhARM and the American Bar Association sit down at a table and figure out how best to screw us.

[edit] Actually our best bet is to divide and conquer. It's easiest to eliminate the American Bar association from the equation because everyone hates lawyers. Then we could possibly appease the AMA and PhARM while socializing the health insurance industry. Or perhaps leave the heatlh insurance alone at first and go after PhARM next. Doesn't matter which, appease them at the expense of one and like true capitalists they'll throw their own mothers to the wolves for an extra nickel, then we can move on to the next one. Divide and conquer. [/edit]

I'm aware of the conversations from which a fair amount of that originated; I should have said "why is this all being dug up and directed at me when I was agreeing with you".

 

That's a bit of a stretch to posit that anyone with a particular opposing viewpoint must have somehow been duped into it. Everyone has some reason for believing what they do, and just because they come to the same conclusion doesn't mean that those reasons must be the same as anyone else with same conclusion, or that they have no reasons at all.

Certainly there are some people who would feel that the free market is best as you commented. Personally (and forgive the slight detour towards the philosophical here, as this applies to life in general and not so specifically to healthcare), I'm of the simple opinion that people should be self-responsible if at all possible. These days that may not be a popular view, but that's how I was raised, and my dad before me, and so on. The bottom line is that nobody looks out for your own interests better than yourself, and when you achieve something under your own power, you tend to feel better about it and life in general. Having things provided for you tends to breed ingratitude and apathy (like the stereotypical snobby rich kid).

Don't jump to berate me just yet, though. Certainly there are those who by circumstance or catastrophe cannot provide for themselves, and yes, their welfare should be seen to (ideally by family or charity, rather than taxation and bureaucracy, but that's another discussion). Preferably any assistance would be given with the goal of returning them to self-sustenance, but obviously that is not always possible either. Either way though, those people should be the exception, not the rule. And of course there are things like security and infrastructure that a government is best suited to handle in a large society (the nebulous "general welfare" of yore) even under the best of circumstances.

On the subject of healthcare particularly, things aren't so simple. As has been said by others, life is not something that one should be deprived of over finance. And as medicine has advanced, costs have gone up. But as we've discussed, there are certainly a lot of unecessary inflating factors in those costs, such as frivolous litigation like you've noted, and much reform and regulation could be enacted to bring things to a reasonable level. This is pretty clearly a place where giving the free market free reign, with patients reduced to figures on stockholder reports, is not the solution.

That having been said, IMO it's not necessarily something the government should be responsible for managing directly either; government involvement tends to introduce excessive bureaucracy, among other things. Some may argue that that is better or worse than pure free market, but in the end, it's just "differently bad", with the same end result that you get less back for a given amount invested (the free market tends to see costs go up but returns stay static, while govt. makes the cost static, but returns go down).

But in the bigger picture, it goes back to what I said above about self-responsibility above. Making it a government responsibility negates the individual benefits of people being self-responsible (for instance, living a healthy lifestyle or reaping the benefits of taking a calculated risk and carrying minimal/no insurance when your health is good), while saddling everyone with the costs of those who chose not to be self-responsible (by living unhealthy lifestyles, or making willful choices with negative health effects). As well, health then becomes "someone else's problem" since your costs are largely fixed regardless of how much you take from the system, and people are even more discouraged from taking active roles in their own welfare. This is probably one of the biggest reasons that I personally oppose fully socialized healthcare.

 

At the end of the day though, it's all a long ways off, and there are a lot of things we do agree on. Yes, healthcare shouldn't be denied to those in need. Yes, the system as it stands is out of control. Yes, a lot of work needs to be done to bring things within reason. Granted, we may differ on the ideal end result, but we agree on the problem and a significant part of the action that needs to be taken, and that's something.

It really wasn't specifically directed at you just because it was your response that I quoted. It was just when someone recites the mantra that there's nothing the government can do without messing up what usually follows is a statement of the superiority of the free market. You stated the first but neglected the second which I just presumed.

Also you weren't precisely agreeing with me. My statement was that I felt there was no chance getting a good outcome on health care reform that anyone would like regardless of their politics. You took that and twisted it to mean that the only thing government can do in *all* cases is to mess things up. That's not what I said and that is *not* something with which I agree.

I never said *anyone* that has an opposing viewpoint must have somehow been duped into it. I said:

Many, not all. Plus I didn't say duped although perhaps that's implied from the closing "talk about ignorance" comment. No doubt there are a myriad of reasons as why someone in the lower socio-economic bracket would side with those in the highest bracket. But I do believe that the overall effect is detrimental to their position in life and I’m simply amazed at how the uber rich are able to do it. I guess they can simply afford the best ad campaign and pull on the right strings to manipulate opinion. Actually duped probably *is* the right word.

And most definitely this was a general statement not specifically relating to healthcare although not specifically excluding it either.

No argument so far. I'm in perfect agreement. Personally I'd like to limit the trust fund/inheritance of that snobby rich kid to ensure that he too had to work for a living but that's a totally different topic.

Why would I jump on you, you’re reading line and verse out of my personal belief system, at least so far. But also note that this isn’t quite in line with the comment that the *only* thing government can do is mess things up.

I’m still waiting for something to disagree with.

Here’s where I think there’s room for argument. I don’t want to make a significant digression and admittedly there is difference of opinion based on the sources that you wish to quote but the most favorable comparison that I could find for your case here is that the administrative cost overhead of Medicare is 5.2% and the administrative cost/profit overhead of the health insurance industry is 8.9%. On the other hand the most unfavorable comparison for your case is that the cost overhead of Medicare is 2% and the administrative cost/profit overhead of the health insurance industry is as high as 33%. Clearly plenty of room for argument however it is interesting to me that even the most favorable comparison is almost 2 to one in favor of Medicare versus the health insurance industry.

Meh. Not totally buying this point, particularly the acceptance of calculated risk part. But let’s say I grant this premise that government supplied insurance removes all financial motivation for a healthy lifestyle, I would argue that a healthy lifestyle is its own reward and there’s plenty of motivation other than financial to aspire to it. Also who’s to say you couldn’t motivate folks financially with a governmental insurance plan? You’ve never heard of a sin tax? Just ask smokers that are paying $6.50 a pack for cigarettes. I’m sure we could have health club tax credits, body mass index penalties and many other incentives short of STFU and die.

Yep.

PS. As far as my statement about have's and have not's it was more a statement about how the party of the uber rich has gotten a good percentage of the rural poor to vote for the benefit of the Haliburton CEO and to their own detriment. Yeah, I understand, family values and the opiate of the masses and don't forget to be afraid of the boogy man.

Beg pardon if I edit a bit so I can "completely agree" in a contrarian way. First, I offer a corollary: the free (truly free) market screws everyone *unequally* because it puts profit above all other values, leads inevitably to the concentration of wealth in the hands of a few, and, because they must put profit first, those few inevitably lose (or always lacked) meaningful relationships with the many who work to build and maintain that wealth.

Second, and more importantly, what Kryo is talking about is *democratic* government. One of the things I had the hardest time imparting to my civics students is that in a democratic system, compromise is the norm, and if *everyone* agrees about a given policy, there's probably something rotten in Denmark. Our deservedly-vaunted Constitution only required a plurality vote to be adopted, and the folks who opposed it helped make it stronger by dint of their critiques. Patrick Henry spat on the thing, but his name is often invoked when people argue about the limits of federal power and the liberties of individual citizens.

To try to get back to the OP, as a sometimes-reluctant convert to democracy, I heartily endorse screwing everyone equally (health care as a public good) over coddling some and seriously screwing others (what we have now in the US).

That's a rather simplified take on it all... I wouldn't quite call a healthcare system that encourages some modicum of individual responsibility "let them die." Psychoak in his normal crass could easily be construed as advocating that (and he might actually be in favor of it), but I am nowhere near that extreme. Nonetheless it was a fresh take, considering that the rest of the thread concentrated on how to take care of the people who can't and won't take care of themselves. Psychoak was just the first to point out that there is a different between the cants and the wonts.

Actually a noticeable amount although not what I or most other non-smokers would like.

To avoid misunderstanding, let me preface the rest of this with the statement that this is not directed exclusively or even necessarily specifically at you.

I agree absolutely.

It's called "reductio ad absurdum". It wasn't I that was lamenting the fact that there was less financial motivation for good behavior in the context of public sector insurance as there is in our current system. I was merely pointing out that there are ways to make up for this lack for those that were essentially using this as an argument against some public form of health insurance.

My own personal opinion is that people should be encouraged to act in their own best interests as creatively as possible as long as that doesn't involve draconian measures for the "rest" of us.

You can do whatever you can to lead a horse to drink but in the end you can't really make him water, or something to that effect.

But you can and should provide them with insurance coverage.

I've been doing a fair amount of thinking about this, and my head is currently flooded with thoughts.  So, for the sake of brevity, I'll just list a couple of them right now, and perhaps elaborate a bit more later if I need to.

Thing is, healthcare in the U.S. is a bit more expensive per person than it is in many other countries.  One thing we should ask is why, and another thing we should ask is how much of a bad thing is that?  One reason why it may be more expensive is that Americans might not be as healthy as a whole as other people in other countries for this that or some other reason.  Americans may be able to afford more, and thus pay more for health care.  Or maybe the American healthcare system is simply less effecient and more wasteful than other systems.  There are many factors that could be contributing to this, and I believe it's very important to figure out why this is happening before we do anything too rash.  

A question arises asking whether or not it'd be a good thing for the government to step in and take control over the whole situation.  The two reasons that I can think of for this would be either because the government can reduce the cost of healthcare, or because it can help redistribute the wealth of individuals so that healthcare can be provided to all.  

Now, I'll explain why in a bit, the but, as far as I can tell, the only "free lunch" you could get with regard to reducing the cost of healthcare is to reduce the ineffecicency and waste in the system.  If the government, by taking control of healthcare can do this better than the private sector, then this should be seriously considered.  Some believe it can, some believe it can't, but I won't argue for this either way here.  However, when it comes to reducing the price of healthcare through other means, say by simply negotiating lower costs with say the pharmaceutical companies, there is a price attached.  See, the way I look at it, many things that seem to help us in the short term actually damage us in the long term, and things that help us in the long term, will likewise have some drawbacks in the short term.

Say that the government made it so that these bottles of X cost $2 a bottle rather than $5.  Well, that means that the company that sells X will now make a substantial amount less in overall profit than they otherwise could have.  Hooray for us little guys right?  Sure, now they may pay fewer dividends to their shareholders and perhaps certain executives will maybe take a pay cut (I'm sure), but a substantial amount of those profits are actually reinvested back into the company, and a lot of that money is used to fund R&D for new drugs later on in the future.  So quite simply, research ventures that may have yeilded an expected profit, may no longer be considered profitable, or the risks are otherwise just too high to give them the green light.  Sure there will be continued research as the company needs to grow some how, but there will most likely be several projects that may have yielded something beneficial for us all down the road, but were no longer being funded.

See, when something costs a lot of money, inefficiency, corruption, and waste aside, that often means that it is very high in demand.  This is a good thing in the long run, because that means that certain enterprising entities will try to capitalize on this demand by creating a corresponding supply.  Now, to provide this supply often requires substantial investment, and if for some reason that investment looks like it won't pay off, it is often not made in the first place.

So, we as people get sick, maybe sick enough that we would otherwise die.  We don't want to get sick and die, so therefore we have a strong demand for doctors and medicine.  It seems to require a lot of work to be a doctor, and medicine costs a lot to make, so therefore we will reward those that provide those supplies for our demands with money.  This makes more people want to become doctors, and more entities to want to research medicine.  If we pay less for these things, but the difficulty in supplying these things remains just as hard, there will be less incentive to become doctors or to research medicine.  Now, if it becomes easier to become a doctor or research medicine, the rewards for doing these things (cost in money) goes down to compensate.

In the end, a choice will have to be made.  You can pay less for healthcare, but risk future investment that could have been done in the field thereby helping you in the short run, but hurting you in the long run, or you can pay more and get the oppossite effect.  There's a trade off here (except for as I said, eliminating waste and ineffeciency as that is a win for both sides), and a balance has to be found.  Finding that balance is the tricky part, but that's generally what the free market is pretty good at doing.

Norway is a fantasy land, literally.  A few million people export more fossile fuels than any country but Saudi Arabia and Russia.  They have one of the lowest population densities in existence with massive natural resources.  For the US to match them with the same amount of effort, we'd need all the oil on the planet under our control.  For the US to be as efficient, we'd just have to kill a few hundred million people off so we had a managable level of infrastructure.

 

They'll find out how fucked up they are when they run out of lazy alternatives to hard work and collapse under their unafforable programs that require twice the sustained income in technological equals.