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Why people are afraid of universal health care

 
 
 
Torin said:
My concern about universal health care is that it seems morally wrong. I hasten to say that I do not intend to accuse you, personally, of being immoral, even if you're taking advantage of similar programs. I do not see how to reconcile universal health care as a political policy with moral principle, though.

The basic issue I perceive is that you are advocating taking money from one person, by force, and giving it to someone else to pay for their medical care without compensation.
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This is straight out of the Hyper-libertarian's song-book. I suppose people also shouldn't be provided with help from fire or flood unless they can pay for it. Perhaps elementary schools should be privatized along the lines of for-profit prisons: Children unable to afford tuition could be put to work cleaning and painting the classrooms?
 
Discussion of American health-care usually ignores the "elephant in the room." Health-care in the U.S. is simply more expensive than it is in other countries. There are several reasons for the high costs:
  • Drug prices are much higher than in other countries.
  • There are an inordinate number of expensive machines. An MRI machine sells for $1 million and up.) The number of such machines is higher than necessary (though hospitals can recover their investment by ordering unnecessary scans).
  • Insurance overheads are unneeded in government-operated health care. (In the U.S. even small practices sometimes need a full-time employee just to interact with insurance adjusters.)
  • A brutal cost/benefit analysis might be appropriate when prescribing expensive treatments for the terminally ill.
  • Malpractice tort awards are a bad approach. Patients with a bad outcome may want compensation whether the outcome is caused by error or not.
  • Salaries of medical professionals. Average physician income in the U.S. is about three times what it is in Germany, even when 5% (average malpractice insurance premium) is subtracted from U.S. income.
I've no "silver bullet" for the final problem. Talented professionals in U.S. have high incomes across-the-board; and America is said to have the best doctors in the world. Subsidized education for talented med students might help?
 
Emily Lake said:
Gospel said:
Torin said:
The basic issue I perceive is that you are advocating taking money from one person, by force, and giving it to someone else to pay for their medical care without compensation.

The principle underlying that proposal can only be that we do not have any right to our property if someone else needs it, which they always do. Even if this specific policy does not take away too many rights (by whatever standard you're using), it is based on the principle that we have no rights against the government. "We're taking your stuff because we own you" is not a moral stance.
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Your argument implies that all taxation is morally equivalent to theft. If that's true, how do you propose funding public goods like roads, police, or national defense? Does your position hold that all government functions based on taxation are illegitimate?

Do you believe it is morally acceptable for someone to die or face unnecessary suffering simply because they cannot afford care? If not, how should society address these cases without redistribution?

Do you disagree that allowing people to die because they cannot afford care would have a collective impact?
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There's a nuance in here, but it's not a bright line by any means.

On the one hand, there are public goods, where all people benefit from them by more or less the same amount. Not exactly the same, but the variance is relatively small. Everyone benefits from roads. Even if one person doesn't drive, they still benefit from the existence of those roads, because they're used for all shipping and transport, to move necessary goods around the country. Sure, there might be a few hidden hermits up in the hills who hunt and grow their own food, who build their own house, and live entirely off the grid... but chances are those hermits also aren't paying taxes, so while they're not benefitting from those roads, they're also not hurt by them.

Many of our tax-funded systems are very similar to roads. It's a collective good, because pretty much everyone who is pitching in for it benefits from it.

On the other hand, there are other programs that are forced charity (for lack of a better term to get my point across). These are programs that only benefit a very few people, but are supported by those who are NOT benefitting from them. Many of these, like school lunch programs, EIT, etc. are acceptable to most people because they're fairly inexpensive to administer. In the grand scheme of things, it's a very small amount being collected from a large number of people, in order to assist a very small number of people. Most of the time, most people are happy to help out someone in need as long as it doesn't hurt them to do so.

Health care is on the gripping hand. It's very, very expensive... but that expense is driven by a relatively small number of people. Speaking as a health actuary with 25 years of experience, it's been demonstrated over and over again that 80% of the cost of health care is generated by 20% of the people; 50% of the cost is generated by 5% of the people. We're not all benefiting more or less the same. But it's also not a small immaterial amount of contribution. Average cost per covered life for employer sponsored coverage is creeping up on $1000 per month. Most people don't incur $1000 of costs in an entire year.

Now the kicker is that most people are already contributing to those health care costs, even if they don't realize it. People purchasing coverage through ACA at least see the actual cost, and they're paying directly (along with subsidies from the government which cover a lot of it). Employees frequently have no idea how much their employer pays on their behalf though, they only ever see their payroll contribution, which can be extremely small. I pay $20 per month for my husband and I... but I also know that the average cost at my employer is over $1000 per person - so my company is paying $920 per person on our behalf every month.

At the end of the day, however, we all have the right to opt out of coverage - we're not forced to participate. That would change if it were universal health care.

Arguments can be made from a premise of morality for either side of this argument. Personally, I don't think morality is the foundation on which this should be built. But that's just me, other people have different perspectives.
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You’ve raised an important nuance about the difference between public goods and redistributive programs, and I appreciate your perspective as a health actuary with deep experience in the field.

You note that many redistributive programs, like school lunches, are widely accepted because they involve small contributions from many to benefit a few. Health care is indeed more costly, but the moral imperative remains. Allowing individuals to suffer or die due to lack of access to care raises ethical questions that extend beyond simple cost-benefit analysis. The question is not just who benefits, but what kind of society we want to build. Do we value human life and dignity enough to ensure that everyone has access to care, even if it requires more substantial redistribution?

It’s true that a disproportionate share of health care costs is driven by a small percentage of the population. However, as you pointed out, most of us are already contributing to these costs through employer-sponsored insurance or other mechanisms. Universal health care simply formalizes and equalizes this process, ensuring that everyone contributes fairly and benefits when they need it. It removes the hidden costs and inefficiencies that exist in the current system, such as emergency room care for the uninsured, which we all ultimately pay for.

You suggest that the ability to opt out of current systems preserves individual choice. While this may seem ideal in theory, in practice, it often leads to gaps in coverage and higher costs for everyone as market-driven approaches often exacerbate inequities and inefficiencies.. Universal systems eliminate these disparities, ensuring a baseline of care for all while potentially allowing for supplemental private insurance for those who want more.

While you mention that morality may not be the foundation for this discussion, I would argue that it must at least be part of the equation. Economic arguments alone can miss the broader human impact of policies. Ensuring health care for all is not just about cost—it’s about reflecting our values as a society.

In summary, I agree that the costs and complexities of health care make it different from simpler public goods like roads. However, I believe this uniqueness makes the case for universal health care even stronger, not weaker. By pooling resources and ensuring equitable access, we address not only the practical challenges but also our collective responsibility** to one another.

**To stay on topic, I recognize that some may reject the notion of collective responsibility while still expecting to enjoy the benefits of collective action, such as military defense, but that’s a separate debate entirely.
 
Torin said:
steve_bank said:
I don't remember how far back.

There was a conservatives propaganda campaign to discredit Canadian socialized health care. The guy who orchestrated eventually fessed up and said he was wrong.

Trump like conspiracy theories. Fear mongering that socialized health care in the USA would lead to socialism-communism and loss of freedoms. One of the old conservative arguments against social programs.

The privatized Medicare insurance programs are a good model.n for national health care It is all those Medicare Advantage insurance ads on TV.

The government gives Medicare money to private insincere companies who have to provide at keast the basic Medicare benefits. Insurance companies compete by adding benefits like dental care.

I have had Medicare Advantage for over 10 years, works fine.
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You are a thoughtful poster, so I thought I would pick your brain a bit.

My concern about universal health care is that it seems morally wrong. I hasten to say that I do not intend to accuse you, personally, of being immoral, even if you're taking advantage of similar programs. I do not see how to reconcile universal health care as a political policy with moral principle, though.

The basic issue I perceive is that you are advocating taking money from one person, by force, and giving it to someone else to pay for their medical care without compensation.

The principle underlying that proposal can only be that we do not have any right to our property if someone else needs it, which they always do. Even if this specific policy does not take away too many rights (by whatever standard you're using), it is based on the principle that we have no rights against the government. "We're taking your stuff because we own you" is not a moral stance.

I do not expect you to agree with me. I just wanted to indicate briefly how I think about this topic, so that I could understand your thinking in turn.

Thanks.
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Your position leads to government itself being improper--but history shows that the people fare better with a government.

Or consider my former boss. He took a position not too different from what you're saying--that those who can't care for themselves aren't owed anything by the state. He ended up on Medicaid for some years.
 
Emily Lake said:
Health care is on the gripping hand. It's very, very expensive... but that expense is driven by a relatively small number of people. Speaking as a health actuary with 25 years of experience, it's been demonstrated over and over again that 80% of the cost of health care is generated by 20% of the people; 50% of the cost is generated by 5% of the people. We're not all benefiting more or less the same. But it's also not a small immaterial amount of contribution. Average cost per covered life for employer sponsored coverage is creeping up on $1000 per month. Most people don't incur $1000 of costs in an entire year.
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And note that going into it nobody knows whether they are going to be one of the cheap ones or the expensive ones. And by the time you know the die has already been cast. Thus the only fair approach is to charge a basically level premium, although charging extra for things that are truly the patient's choice is acceptable to me. (For example, smoking.) Anything else, you're going to penalize a lot of people who had no choice in the matter.
 
bilby said:
And in the case of medical insurance, opting out, and then having your unlucky number come up, is NOT a problem for you alone. Even in the unlikely event that you want to refuse care, others are harmed by your refusal. Whether because you are spreading your untreated infection, or because they need to clean up your vomit or blood, or just because they care about your plight.
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Depends on what you opt out of. I would opt out of a lot of cancer treatments (too much of it is buying time in hell, not actually living), that would not impose costs on anyone.
 
I don't know if people are actually afraid of universal healthcare, but it does seem that CEOs of private health insurance corporations that fail the "don't be evil" test should fear their customers.

https://www.bbc.com/news/articles/cnv3dnm64vlo

New York City police have launched a manhunt for a masked suspect who gunned down the head of a US medical insurance giant, in what investigators described as a "brazen, targeted attack".

UnitedHealthcare chief executive Brian Thompson was fatally shot in the back on Wednesday morning outside the Hilton Hotel in Midtown Manhattan, where he had been scheduled to speak at an investor conference later in the day.
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I would hope that other insurance company bosses might learn from this that they should care more about their customers as human beings, rather than just as sources of revenue. But I expect that they will instead simply hire more personal security.
 
bilby said:
I don't know if people are actually afraid of universal healthcare, but it does seem that CEOs of private health insurance corporations that fail the "don't be evil" test should fear their customers.

https://www.bbc.com/news/articles/cnv3dnm64vlo

New York City police have launched a manhunt for a masked suspect who gunned down the head of a US medical insurance giant, in what investigators described as a "brazen, targeted attack".

UnitedHealthcare chief executive Brian Thompson was fatally shot in the back on Wednesday morning outside the Hilton Hotel in Midtown Manhattan, where he had been scheduled to speak at an investor conference later in the day.
Click to expand...
I would hope that other insurance company bosses might learn from this that they should care more about their customers as human beings, rather than just as sources of revenue. But I expect that they will instead simply hire more personal security.
Click to expand...
I don't know about their history of customer service, but as one of the largest providers of Advantage plans, I have received good service. And, they are accepted by most doctors.
 
It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.
 
Torin said:
It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.
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People are murdered everyday. This person had no more value than the next. Most often the murder had some grudge against the victim as only 10-12% of murders are random. This one had messages scrawled on the bullet casings.
 
Torin said:
It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.
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Right, and it's not the time to talk about gun violence after a school shooting. This thread started almost 2 months before this incident and universal healthcare has been a frequent subject on this board and almost all of its predecessors. Apparently the only time to talk about topics that offend you is never.

aa
 
Torin said:
It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.
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I remember calling 911 so many times when my youngest was little. She had severe asthma and it often acted up in the middle of the night. She'd come staggering into my room, barely able to breathe. I'd frantically call 911 and then lay her on the floor and have her hit her inhaler until they got there. Her face, her lips would get so pale. I cannot adequately describe how horrific it was watching my little girl go through this and that this was how she might actually die.

I remember having to follow the ambulance to the ER at 1 or 2 in the morning, terrified for her and feeling so fucking helpless.

We had Anthem/Blue Shield at the time. The deductible was 5K. It was all that was offered. A gigantic "Fuck You. Take It Or Leave It."

The fear that my child was going to die was coupled with the humiliation of wondering how I was going to pay for her treatment.

So some mega health insurance CEO got gunned down. Boo-motherfucking-hoo. Neither that cocksucker nor any other fucking ghoul like him ever gave two thoughts about people like me or my kids. Why on fucking earth should I feel anything for him or anyone in his family?

Frankly, it's shocking it hasn't happened sooner. And if it happens again? Well, sorry, I'm going to have to deny any requests for sympathy because it won't be in my network.
 
BC resident here (yay more anecdotal stuff) I just went through a heart procedure to repair a congenital issue. I was prioritized by risk and everything was A1. Bit of a wait, yes, but all within acceptable time limits based on my condition. Paid zero for entire deal. I know it comes off my taxes, but I didn’t have to take out a second mortgage. You really appreciate it when you need it.

US really has to do this
 
robnisch said:
bilby said:
I don't know if people are actually afraid of universal healthcare, but it does seem that CEOs of private health insurance corporations that fail the "don't be evil" test should fear their customers.

https://www.bbc.com/news/articles/cnv3dnm64vlo

New York City police have launched a manhunt for a masked suspect who gunned down the head of a US medical insurance giant, in what investigators described as a "brazen, targeted attack".

UnitedHealthcare chief executive Brian Thompson was fatally shot in the back on Wednesday morning outside the Hilton Hotel in Midtown Manhattan, where he had been scheduled to speak at an investor conference later in the day.
Click to expand...
I would hope that other insurance company bosses might learn from this that they should care more about their customers as human beings, rather than just as sources of revenue. But I expect that they will instead simply hire more personal security.
Click to expand...
I don't know about their history of customer service, but as one of the largest providers of Advantage plans, I have received good service. And, they are accepted by most doctors.
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Should I be concerned now that we found out what the motive was for this murder?
 
robnisch said:
robnisch said:
bilby said:
I don't know if people are actually afraid of universal healthcare, but it does seem that CEOs of private health insurance corporations that fail the "don't be evil" test should fear their customers.

https://www.bbc.com/news/articles/cnv3dnm64vlo

New York City police have launched a manhunt for a masked suspect who gunned down the head of a US medical insurance giant, in what investigators described as a "brazen, targeted attack".

UnitedHealthcare chief executive Brian Thompson was fatally shot in the back on Wednesday morning outside the Hilton Hotel in Midtown Manhattan, where he had been scheduled to speak at an investor conference later in the day.
Click to expand...
I would hope that other insurance company bosses might learn from this that they should care more about their customers as human beings, rather than just as sources of revenue. But I expect that they will instead simply hire more personal security.
Click to expand...
I don't know about their history of customer service, but as one of the largest providers of Advantage plans, I have received good service. And, they are accepted by most doctors.
Click to expand...
Should I be concerned now that we found out what the motive was for this murder?
Click to expand...
www.thedailybeast.com

Moderators Delete Reddit Thread as Doctors Torch Dead UnitedHealthcare CEO

“When other’s human lives are deemed worthless, it is not surprising to have others view your life of no value as well,” wrote one medical doctor, whose identity the Daily Beast confirmed.
www.thedailybeast.com www.thedailybeast.com
Crap!
 
robnisch said:
robnisch said:
robnisch said:
bilby said:
I don't know if people are actually afraid of universal healthcare, but it does seem that CEOs of private health insurance corporations that fail the "don't be evil" test should fear their customers.

https://www.bbc.com/news/articles/cnv3dnm64vlo

New York City police have launched a manhunt for a masked suspect who gunned down the head of a US medical insurance giant, in what investigators described as a "brazen, targeted attack".

UnitedHealthcare chief executive Brian Thompson was fatally shot in the back on Wednesday morning outside the Hilton Hotel in Midtown Manhattan, where he had been scheduled to speak at an investor conference later in the day.
Click to expand...
I would hope that other insurance company bosses might learn from this that they should care more about their customers as human beings, rather than just as sources of revenue. But I expect that they will instead simply hire more personal security.
Click to expand...
I don't know about their history of customer service, but as one of the largest providers of Advantage plans, I have received good service. And, they are accepted by most doctors.
Click to expand...
Should I be concerned now that we found out what the motive was for this murder?
Click to expand...
www.thedailybeast.com

Moderators Delete Reddit Thread as Doctors Torch Dead UnitedHealthcare CEO

“When other’s human lives are deemed worthless, it is not surprising to have others view your life of no value as well,” wrote one medical doctor, whose identity the Daily Beast confirmed.
www.thedailybeast.com www.thedailybeast.com
Crap!
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From that article:
Law enforcement officials found the words “deny,” “defend” and “depose” on shell casings recovered from the crime scene and are reportedly examining whether they can be connected to a motive involving insurance companies.
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Who is running this investigation? Mr Magoo?

The motive is obvious; But it is unlikely to help the investigation, as knowing it only narrows the pool of suspects to around 100,000,000 people.
 
This isn’t going to end with the billionaire class and their lickspittle behaving better. As the GOP eliminates all agencies that do anything to protect public health and corporate accountability, these clowns are going to wall up behind heavily armed and unaccountable private security. In most cases they’ll have government law enforcement and the courts on their side too. Like southern WVA in the late 19th and early 20th centuries.
 
Emily Lake said:
At the end of the day, however, we all have the right to opt out of coverage - we're not forced to participate. That would change if it were universal health care.

Arguments can be made from a premise of morality for either side of this argument. Personally, I don't think morality is the foundation on which this should be built. But that's just me, other people have different perspectives.
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People that don't pay for insurance are stealing from me and my premiums. Unless someone was born in a barn, delivered by a mule (donkey, not drug trafficker), they need to pay into the system they used. It is past tense... already happened. The hospital didn't just pop up to provide services for one birth. It needed to be there. Waiting. This is also ignoring that unless one is a hermit that never interacts with humans, it is almost a certainty that they will use the health care system at some point.

The health care system is a massively complicated thing that requires endless investment to exist, even if one only begrudgingly uses it once every 30 years. Opting out of paying for hospitals, doctors, would be like opting out of paying for roads. We all benefit (even as a third source!) with illness, injuries being managed quicker which helps the economy. Medical services are no less a necessity to Americans than the roads or electricity. We all need to pay.
 
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