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Why people are afraid of universal health care

laughing dog said:
Loren Pechtel said:
laughing dog said:
Loren Pechtel said:
bilby said:
Loren Pechtel said:
laughing dog said:
Why would anyone assume that a YHC would not have some form of outside rsgulation?
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Who? It's the government setting the standard of care. It's the government providing the care. That's a fox guarding the henhouse.
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That's no less absurd than saying of any system "It's humans setting the standard of care. It's humans providing the care. That's a fox guarding the henhouse".

"The government" is not a monolithic entity. It is a society in its own right, and is divided into competing departments and divisions.

Would you suggest that an officer from the airforce could not fairly referee an army vs navy football game, on the basis that it's all "The Military"?

No wonder American politics is so fucked up; The people can't seem to grasp that they don't live in a dictatorship. Shit, even one of the two candidates for this year's presidential election can't seem to grasp that the US government is not the power apparatus by which the President rules as an autocrat.
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No. The problem comes with any organization that self-regulates. Look what has happened recently with Boeing--the FAA was permitting them to do a lot of their own inspections. Oops. You need as much of a separation as can reasonably be accomplished.
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Let me get this straight. The FAA -an independent regulator - screwing up is your reason for wanting an independent regulator.

It appears you are letting the perfect get in the way of the good.
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No--the Republicans crippled the FAA to the point that they allowed Boeing to do their own inspections because the FAA wasn't able to.
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But the FAA was an independent regulator.

The obvious point that eludes you is that an effective overseer is necessary for accountable, not its affliation.
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I didn't say an independent overseer is inherently sufficient to ensure proper oversight. I only claimed it was necessary.
 
bilby said:
Boeing can't self regulate because it's primary motive is profit, and it is accountable to the Boeing board for both profitability and regulatory actions. Internal regulators are under the control of the same board of directors who want corners to be cut.

The GAO has no such motive; It's job is to audit government departments, and it won't cut them any slack 'because they are government too'. The Comptroller General has no motive to let other federal agencies get away with anything; The GAO is as independent as it is possible for any regulator to be.

Government auditors have as much separation from those they regulate as can reasonably be accomplished. Your belief that they are not separate because they both have the label "government" is a failure to grasp how governments work.
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The problem runs deeper--it's not just the auditors, but the rules themselves. That's what I'm worried about--defining down the standards. That's Congress, not the GAO.
 
Elixir said:
Loren Pechtel said:
Elixir said:
Well… we have the raw numbers from COVID.
While enduring an estimated one million “excess deaths” we (Trump) ran up a 7 trillion $ debt. So with inflation, the number has to be around $7m/citizen.
If I knew I was worth that much I’d have sold out long ago! 😲
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There are no lives saved here to be making the comparison.
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WTF are you comparing/talking about?
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That $7T is basically the cleanup cost, not the lifesaving cost. We didn't do a lot of life saving.
 
Bomb#20 said:
I think that was LP's point, and I see some merit in it. "Regulators are all going to be captured anyway so let's just design the capture in from the get-go and treat it as a feature, not a bug." seems unnecessarily defeatist to me. Moving along the spectrum toward the independent end is of course swimming against the current, but if a regulatory agency turns out to be unreformable the government always has the option of creating a brand new regulatory agency to replace it. That's probably easier than creating a brand new industry for the government to operate itself.
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I want the regulators to be as independent as is feasible, both in enforcement and in rule-making. It's the rule-making part I'm really worried about.
 
Loren Pechtel said:
That $7T is basically the cleanup cost, not the lifesaving cost.
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Sorry - that’s another 7t$
The 7t$ I’m talking about mostly went into the pockets of major trump donors and onto the national debt balance sheet.
 
Bomb#20 said:
And in any event, if we decide cost and efficiency don't matter and what we want is for the system to be popular amongst patients, forecasting whether a proposed system will be popular with patients is a hard technical problem of economics. You can't just postulate the system of your dreams and expect it to necessarily work out in practice the way you envision. Patient experience will depend on myriad decisions by doctors, nurses, researchers, manufacturers and so forth, and all those people's decisions will depend on the incentives the system gives them. Economics is pretty much just the science of incentive.
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And note that medical costs are very disproportionately distributed. Remember that we are a democracy. Consider a policy of silently screwing the most expensive x% of patients. Of course they'll see what's happening and vote against you. Probably their families will also. But others will not see the problem and vote for you because you lowered the cost. Think about it--x can be a few percent and yet the voters will favor it. In time some will learn, but there will always be a new crop of voters. So long as the failures aren't too widespread or too obvious it's what the system will do. And note that x can be a substantial percent of those with serious medical issues that are not things that must be done right now. Like the woman whose blog I linked.
 
Loren Pechtel said:
bilby said:
Boeing can't self regulate because it's primary motive is profit, and it is accountable to the Boeing board for both profitability and regulatory actions. Internal regulators are under the control of the same board of directors who want corners to be cut.

The GAO has no such motive; It's job is to audit government departments, and it won't cut them any slack 'because they are government too'. The Comptroller General has no motive to let other federal agencies get away with anything; The GAO is as independent as it is possible for any regulator to be.

Government auditors have as much separation from those they regulate as can reasonably be accomplished. Your belief that they are not separate because they both have the label "government" is a failure to grasp how governments work.
Click to expand...
The problem runs deeper--it's not just the auditors, but the rules themselves. That's what I'm worried about--defining down the standards. That's Congress, not the GAO.
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So vote for better congressmen.

Or better still, give the job of making the rules to an independent agency. Or agencies.
 
Loren Pechtel said:
laughing dog said:
Loren Pechtel said:
laughing dog said:
Loren Pechtel said:
bilby said:
Loren Pechtel said:
laughing dog said:
Why would anyone assume that a YHC would not have some form of outside rsgulation?
Click to expand...
Who? It's the government setting the standard of care. It's the government providing the care. That's a fox guarding the henhouse.
Click to expand...
That's no less absurd than saying of any system "It's humans setting the standard of care. It's humans providing the care. That's a fox guarding the henhouse".

"The government" is not a monolithic entity. It is a society in its own right, and is divided into competing departments and divisions.

Would you suggest that an officer from the airforce could not fairly referee an army vs navy football game, on the basis that it's all "The Military"?

No wonder American politics is so fucked up; The people can't seem to grasp that they don't live in a dictatorship. Shit, even one of the two candidates for this year's presidential election can't seem to grasp that the US government is not the power apparatus by which the President rules as an autocrat.
Click to expand...
No. The problem comes with any organization that self-regulates. Look what has happened recently with Boeing--the FAA was permitting them to do a lot of their own inspections. Oops. You need as much of a separation as can reasonably be accomplished.
Click to expand...
Let me get this straight. The FAA -an independent regulator - screwing up is your reason for wanting an independent regulator.

It appears you are letting the perfect get in the way of the good.
Click to expand...
No--the Republicans crippled the FAA to the point that they allowed Boeing to do their own inspections because the FAA wasn't able to.
Click to expand...
But the FAA was an independent regulator.

The obvious point that eludes you is that an effective overseer is necessary for accountable, not its affliation.
Click to expand...
I didn't say an independent overseer is inherently sufficient to ensure proper oversight. I only claimed it was necessary.
Click to expand...
The FAA is structurally independent of the airline industry. Regulatory capture could happen under arrangement. So why even bring it up?
 
Loren Pechtel said:
Bomb#20 said:
I think that was LP's point, and I see some merit in it. "Regulators are all going to be captured anyway so let's just design the capture in from the get-go and treat it as a feature, not a bug." seems unnecessarily defeatist to me. Moving along the spectrum toward the independent end is of course swimming against the current, but if a regulatory agency turns out to be unreformable the government always has the option of creating a brand new regulatory agency to replace it. That's probably easier than creating a brand new industry for the government to operate itself.
Click to expand...
I want the regulators to be as independent as is feasible, both in enforcement and in rule-making. It's the rule-making part I'm really worried about.
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That doesn’t worry you when it cones to law enforcement.
 
ZiprHead said:
Morality should be included in all economic discussions. By pure economic standards, we would just kill all prisoners who get a life sentence. Incurable disease? Kill the patient. Disabled child requiring lifetime care? Kill the child. Slavery? Sure!
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:rolleyes:

I'd prefer to address this via ethics rather than morality.

For most of my life, I supported capital punishment. I still have no moral objection to the death penalty in some very particular situations. At heart, I still think it's more compassionate for both the prisoner and the public to execute those who would otherwise be held without liberty for their entire remaining life. You know why I support LWOP? Because it actually costs less than the various options the US uses for execution. That's the only reason.

Incurable diseases that can be effectively managed are certainly no reason to euthanize the patient - but terminal disease, especially ones that cause either immense pain or significant cognitive deterioration? Those I 100% support a person's right to choose to end their own life with support and compassion. I think it's an absolute travesty that we treat our pets with more care and dignity than we do humans.

For most situations, parents are happy enough to care for a severely disabled child. But there may also be instances where an infant is so disabled that they won't have any meaningful quality of life, and requiring that their parents must suffer twofold seems to lack compassion. It's certainly not something I would support being used with abandon, but I also don't think it should always be disallowed. I'd prefer that such decisions be made prior to birth whenever possible. Consequently, that means allowing for medically justified terminations of pregnancy after viability, which I fully support.

Slavery? I suppose no post is complete without a leap into absurdity, so I guess I shouldn't be surprised.
 
Bomb#20 said:
IIRC some economist did a calculation, based on observed tradeoffs, that the U.S. government valued a citizen's life at $6,000,000, the Japanese government valued a citizen's life at $60,000, and the Vietnamese government valued a citizen's life at $600.
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Life insurance pretty regularly applies a dollar value to a person's life. For some people, they purchase universal life while they're young, with COL inflators etc, and end up in a pretty good spot. Most people get their term life through their employer... and then the value of your life is some multiple of your annual wage.
 
bilby said:
Bomb#20 said:
Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.
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Is it?

Which is cheaper, or more efficient, I can see as a hard technical problem of economics.

Whether to make cost, or efficiency, or something else - popularity amongst patients, for example; Or effectiveness in reaching those least able to provide for their own care - that is a problem of moral philosophy.
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Where does your morality fall on putting tens of thousands of people out of work because you've intervened to eliminate an entire sector of the economy? Where does your morality fall on figuring out how to fund UHC, and which people are harmed by increased cost burdens that they would be faced with in the form of taxes they don't currently pay?
 
Emily Lake said:
bilby said:
Bomb#20 said:
Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.
Click to expand...
Is it?

Which is cheaper, or more efficient, I can see as a hard technical problem of economics.

Whether to make cost, or efficiency, or something else - popularity amongst patients, for example; Or effectiveness in reaching those least able to provide for their own care - that is a problem of moral philosophy.
Click to expand...
Where does your morality fall on putting tens of thousands of people out of work because you've intervened to eliminate an entire sector of the economy?
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That's life. No sector of the economy is entitled to exist if it is no longer required; Ask the British coal miners, or the ostlers, farriers, and livery stable owners.
Emily Lake said:
Where does your morality fall on figuring out how to fund UHC, and which people are harmed by increased cost burdens that they would be faced with in the form of taxes they don't currently pay?
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Given the current price paid for healthcare in the US compared with other OECD nations UHC, the question will rather be "Which people will benefit, from their taxes rising by less than their insurance payments fall?" - and the answer could well be 'Everybody', if the system is structured appropriately.

No nation on Earth spends as much per capita on healthcare as the USA, and no OECD nation has such a low life expectancy for each per capita dollar spent. Clearly there's room for a US UHC system to be both cheaper and better than her current arrangement.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
 
bilby said:
No nation on Earth spends as much per capita on healthcare as the USA, and no OECD nation has such a low life expectancy for each per capita dollar spent.
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That’s the inconvenient truth that billions of dollars are spent to conceal, despite being as plain as black and white.
 
Emily Lake said:
bilby said:
Bomb#20 said:
Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.
Click to expand...
Is it?

Which is cheaper, or more efficient, I can see as a hard technical problem of economics.

Whether to make cost, or efficiency, or something else - popularity amongst patients, for example; Or effectiveness in reaching those least able to provide for their own care - that is a problem of moral philosophy.
Click to expand...
Where does your morality fall on putting tens of thousands of people out of work because you've intervened to eliminate an entire sector of the economy? Where does your morality fall on figuring out how to fund UHC, and which people are harmed by increased cost burdens that they would be faced with in the form of taxes they don't currently pay?
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Your responses assumes a certain type of UHC which need not be the case. There is no reason to expect that necessarily tens of thousands will be put out of work or that the increased cost would necessarily be onerous.
 
Toni said:
Don't get me wrong: In theory, I am absolutely 100% in favor of UHC! I'm very much concerned about how that plays out in reality. I wonder very much how stellar medical care systems in the US such as Johns Hopkins, Cleveland Clinic and Mayo Clinic and a few others will be affected and what it means. Heck, I'm worried about how I will be affected when my husband retires and we go on Medicare. Less so for myself than for my husband who has had more than his fair share of serious medical issues that were discovered and dealt with by our very good providers/system. If we had relied on our town's medical clinic, I would be a widow, for certain, likely after years of serious declining health for my husband. This is based on how they dealt with--or failed to deal with a serious issue some years back that was effectively and efficiently dealt with by our current health care provider with a minimum of drama. No thank you. I prefer my hubby above ground...

UHC would have the large advantage of not needing the same level of bureaucracy to process payments and coordinate payments and care. That alone would be a huge savings. I am mostly concerned with politicians playing politics with 'cost savings' measures.
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The thing that gets me about the whole debate is that here in 'Murica, we claim to be the best at everything...and in some cases rightly so. We're the richest country hands-down, have the most powerful military by a long shot, and the stereotypical "we sent a man to the Moon" thing.

Universal healthcare? "Ooh...that's a nut we can't crack. May as well just leave it up to the private sector!"

As the talking point goes, almost every other "first world" country on the planet has some form of universal/national health care, but for some reason the "greatest country in the world" not only can't figure out how to come up with something to equal those other systems, but can't make something better? I'd think that the "America is best in the world at everything" types would take that as a challenge. Sadly, no.

Tomorrow morning, I'm going in for a CT scan that my doctor ordered. I'll probably have to pay out of pocket because the lab is not "in network." Later, I'll be going to pick up equipment for an at-home sleep study, because despite what my pulmonologist said, an in facility visit is "not medically necessary." The private sector insurance company is overriding my doctor and making medical decisions for me based on profit margins. This can't be the best way to do things, right?
 
Emily Lake said:
ZiprHead said:
Morality should be included in all economic discussions. By pure economic standards, we would just kill all prisoners who get a life sentence. Incurable disease? Kill the patient. Disabled child requiring lifetime care? Kill the child. Slavery? Sure!
Click to expand...
:rolleyes:

I'd prefer to address this via ethics rather than morality.

For most of my life, I supported capital punishment. I still have no moral objection to the death penalty in some very particular situations. At heart, I still think it's more compassionate for both the prisoner and the public to execute those who would otherwise be held without liberty for their entire remaining life. You know why I support LWOP? Because it actually costs less than the various options the US uses for execution. That's the only reason.

Incurable diseases that can be effectively managed are certainly no reason to euthanize the patient - but terminal disease, especially ones that cause either immense pain or significant cognitive deterioration? Those I 100% support a person's right to choose to end their own life with support and compassion. I think it's an absolute travesty that we treat our pets with more care and dignity than we do humans.

For most situations, parents are happy enough to care for a severely disabled child. But there may also be instances where an infant is so disabled that they won't have any meaningful quality of life, and requiring that their parents must suffer twofold seems to lack compassion. It's certainly not something I would support being used with abandon, but I also don't think it should always be disallowed. I'd prefer that such decisions be made prior to birth whenever possible. Consequently, that means allowing for medically justified terminations of pregnancy after viability, which I fully support.

Slavery? I suppose no post is complete without a leap into absurdity, so I guess I shouldn't be surprised.
Click to expand...
All those are the most economical ways to pay the least money support society, unless you include morality.
 
ZiprHead said:
All those are the most economical ways to pay the least money support society, unless you include morality.
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Why pay more? You can’t buy ethics!
(It’s not like morals that way)
No wait, I got that backwards.
But I actually agree with Emily on this.
And whatshisname Singer who said a happy cat is is worth more than a miserable human. It horrified people, but honestly - which would you rather be around?
 
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