Why people are afraid of universal health care

[Emily Lake]

Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.

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.

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?

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.

Selective compassion that allows you to disregard the negative impact of pet policies is always so enlightening.

Fuck those people, as long as you get what you think is right. Fuck the entire economy, put tens of thousands of people out of work with no alternative for them, but hey, no big... you get UHC and you can thumb your nose at the plight of the "collateral damage". No big.

I think you are going a bit overboard there. Would you feel the same way if cures for the cold, cancer, and all genetic disorders were found and threw all those people out of work as well? Industries and jobs come and go in a dynamic economy. Civilized countries try to help those displaced by such changes, but such changes occur.

I think you're underplaying it LD. Yes, industries change over time as technology and knowledge evolve. But you know damned well that this is an entirely different situation from when the government takes it upon itself to eliminate an entire sector.

 

[Emily Lake]

What the fuck laws do you think I support?

I’m assuming you haven’t changed your mind? Still need a law against optional late term abortion?
Why? Or did I misunderstand you?

You've been willfully misunderstanding me from the beginning.

 

[laughing dog]

Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.

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.

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?

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.

Selective compassion that allows you to disregard the negative impact of pet policies is always so enlightening.

Fuck those people, as long as you get what you think is right. Fuck the entire economy, put tens of thousands of people out of work with no alternative for them, but hey, no big... you get UHC and you can thumb your nose at the plight of the "collateral damage". No big.

I think you are going a bit overboard there. Would you feel the same way if cures for the cold, cancer, and all genetic disorders were found and threw all those people out of work as well? Industries and jobs come and go in a dynamic economy. Civilized countries try to help those displaced by such changes, but such changes occur.

I think you're underplaying it LD. Yes, industries change over time as technology and knowledge evolve. But you know damned well that this is an entirely different situation from when the government takes it upon itself to eliminate an entire sector.

Not really. If UHC were to come to play with only a single public sector, it would not occur overnight. There'd be plenty of warning to even the dimmest wits. And there is no way for a purely public sector UHC to run without expanding its workforce. So those employees would have the time to find other employment.

 

[Ford]

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,

In terms of total GDP, sure. But not per capita. The US is up there, definitely, but not the top dog.

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.

It depends entirely on whether or not the average american believes that Universal Health Care is the best in terms of being able to deliver both needed and desired care.

You may have missed it, but average Americans believe all sorts of things, including voting for candidates who promise them the Moon, but will actually harm them. Plus we have a huge PR and lobbying apparatus constantly telling the American people that universal/national healthcare is "socialism," and that the multi-billion-dollar insurers really have our best interests at heart.

Give me a break.

 

[Elixir]

In AZ, the hispanic and native american populations just don't use health care except for injuries and major emergencies.

There was a conference I used to attend as a supporting vendor, that was specifically about First Nations medical issues. It’s tempting to give them total sovereignty and a per capita federal HC allowance. It’s WAAAay complicated.

 

[bilby]

Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.

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.

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?

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.

Selective compassion that allows you to disregard the negative impact of pet policies is always so enlightening.

Fuck those people, as long as you get what you think is right. Fuck the entire economy, put tens of thousands of people out of work with no alternative for them, but hey, no big... you get UHC and you can thumb your nose at the plight of the "collateral damage". No big.

Really?

You think Health Insurance Systems should be kept going, just to insure the employment of Health Insurance workers, even if there's a better way to provide healthcare?

Do you feel it is incumbent on the government also to refuse to use computers, to defend the jobs of millions of typists and file clerks?

If you restructured your business, would you keep employing redundant personnel in their old, now useless, roles, out of pure compassion? I rather doubt it.

 

[bilby]

Maybe your countries should pick up a fair share of the tab for both health care and military?

Assuming you are right (you're probably not) and Healthcare and Defence outside the USA were being heavily subsidised by the USA, It would be entirely up to the USA - we will start buying more of our own, just as soon as you decide to stop spending insane amounts of money to prop up ours.

Until then, why would we?

If you choose to give away loads of free stuff, it's bizarre and insane to then resent the recipient, or berate him for not buying his own stuff. Nobody asked you to put yourselves in this position.

Indeed, I am explicitly lobbying, right here in this thread, for the US to get out of the expensive and needless game of propping up Pharmaceutical giants, to the alleged general benefit of the rest of the world.

 

[Elixir]

You think Health Insurance Systems should be kept going, just to insure the employment of Health Insurance workers, even if there's a better way to provide healthcare?

It would be cheaper and more effective to provide UHC, pay all their salaries for a year and send them all home, than to keep going the way we are.

 

[bilby]

I'm anxiously awaiting your proposal for a UHC solution that does NOT eliminate the Health Insurance sector

The British United Provident Association was the largest health Insurer in the UK, prior to the introduction of the NHS.

That company, now known as BUPA, was eliminated, and ...

Oh, wait.

Shit.

https://en.wikipedia.org/wiki/Bupa

 

[bilby]

In my experience, much of "new" drug development consists of finding ways to make a bioequivalent molecule to an existing 'blockbuster' medication, that has sufficent differences from the original so as to persuade the regulators that it doesn't infringe the patent.

Your experience is limited.

As is everyone's.

I only worked for a global pharmaceutical company (we had an FDA license, and exported several products to the USA, mostly benzodiazepines and cardiac medication) for about fifteen years, finishing up as Demand Planning Manager, having worked my way up from the very bottom of the Operations department, unloading deliveries at Goods Inwards. One of my projects was a company wide shift to Activity Based Costing for our manufacturing campus, including both R&D departments, during which I had instructions from the Directors to literally stick my nose into every aspect of the business.

If your experience of the industry is more extensive, please feel free to share.

 

[Elixir]

Why do you always have to be so hostile and nasty, Elixir? Why do you have to immediately jump to egregiously insulting insinuations?

I apologize. No promise I won’t do it again though. I’ve been battling the urge to jump to egregiously insulting insinuations since I was a teenager. There’s probably a clinical name for it, but I can’t afford a shrink.

 

[bilby]

Australia buying military arms, systems, planes, etc. from the US isn't subsidizing the US.

It's certainly keeping lots of Americans employed at such boutique micro-businesses as General Dynamics and McDonnell Douglas.

 

[Toni]

The USA has past glories but is now in a situation where Caligula could be your next emperor. How the mighty have fallen.

Not fallen so much as laid down and rolled over in the mud.

 

[Emily Lake]

Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.

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.

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?

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.

Selective compassion that allows you to disregard the negative impact of pet policies is always so enlightening.

Fuck those people, as long as you get what you think is right. Fuck the entire economy, put tens of thousands of people out of work with no alternative for them, but hey, no big... you get UHC and you can thumb your nose at the plight of the "collateral damage". No big.

Really?

You think Health Insurance Systems should be kept going, just to insure the employment of Health Insurance workers, even if there's a better way to provide healthcare?

Do you feel it is incumbent on the government also to refuse to use computers, to defend the jobs of millions of typists and file clerks?

If you restructured your business, would you keep employing redundant personnel in their old, now useless, roles, out of pure compassion? I rather doubt it.

Sure, that's totally what I said way back here:

I generally like the idea of making the delivery of healthcare a public good. Under my preferred approach, all doctors, nurses, hospitals, and other facilities would be owned and operated by the federal government, with professional staff paid a salaried wage. The government could then set a reasonable fee schedule to charge insurers - and potentially even offset the needed taxes through that means. It would allow employers to continue providing health insurance to their employees, since that's one of the ways that companies compete for staff. It would allow the current insurance industry to continue under something much more like Medicare Advantage. I think that would cause the greatest benefit to citizens with the least disruption and job loss. I'm sure there are some wrinkles that need to be ironed out, but that's generally my starting point.

 

[Elixir]

What the fuck laws do you think I support?

I’m assuming you haven’t changed your mind? Still need a law against optional late term abortion?
Why? Or did I misunderstand you?

You've been willfully misunderstanding me from the beginning.

Perhaps my comprehension is lacking, as is yours regarding my “willfulness”.
Absent a more comprehensible articulation of your position, telling me my understanding is defective doesn’t contribute to improving it.

 

[Emily Lake]

In my experience, much of "new" drug development consists of finding ways to make a bioequivalent molecule to an existing 'blockbuster' medication, that has sufficent differences from the original so as to persuade the regulators that it doesn't infringe the patent.

Your experience is limited.

As is everyone's.

I only worked for a global pharmaceutical company (we had an FDA license, and exported several products to the USA, mostly benzodiazepines and cardiac medication) for about fifteen years, finishing up as Demand Planning Manager, having worked my way up from the very bottom of the Operations department, unloading deliveries at Goods Inwards. One of my projects was a company wide shift to Activity Based Costing for our manufacturing campus, including both R&D departments, during which I had instructions from the Directors to literally stick my nose into every aspect of the business.

If your experience of the industry is more extensive, please feel free to share.

I find it very disingenuous when you trim out the actual response in favor of a sound bite that you can misrepresent. FFS, it's like you're trying to pretend that the rest of the post didn't exist. You know that everyone else can see it, right? This part:

Don't get me wrong - there's a lot of shenanigans from Pharmaceutical companies, but I'm not going to go on a rant about albuterol today.

What you're missing in your "experience" are things like treatment and preventive medicines for HIV, cures for Hep-C, gene-therapies for a host of cancers and congenital conditions. The FDA approves a whole host of novel drugs every year, and a substantial portion of the original research and clinical trials for those drugs happen in the US, and are subsidized by the US.

You know, the part where I acknowledge that patent plays are a problem but that there's a lot of novel work that goes on and it's important?

But hey, if it's more important for you to get your punches in so your self esteem doesn't suffer, go right ahead.

 

[bilby]

Whether to have an NHS or a mixed public/private medical system is a hard technical problem of economics.

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.

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?

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.

Selective compassion that allows you to disregard the negative impact of pet policies is always so enlightening.

Fuck those people, as long as you get what you think is right. Fuck the entire economy, put tens of thousands of people out of work with no alternative for them, but hey, no big... you get UHC and you can thumb your nose at the plight of the "collateral damage". No big.

Really?

You think Health Insurance Systems should be kept going, just to insure the employment of Health Insurance workers, even if there's a better way to provide healthcare?

Do you feel it is incumbent on the government also to refuse to use computers, to defend the jobs of millions of typists and file clerks?

If you restructured your business, would you keep employing redundant personnel in their old, now useless, roles, out of pure compassion? I rather doubt it.

Sure, that's totally what I said way back here:

I generally like the idea of making the delivery of healthcare a public good. Under my preferred approach, all doctors, nurses, hospitals, and other facilities would be owned and operated by the federal government, with professional staff paid a salaried wage. The government could then set a reasonable fee schedule to charge insurers - and potentially even offset the needed taxes through that means. It would allow employers to continue providing health insurance to their employees, since that's one of the ways that companies compete for staff. It would allow the current insurance industry to continue under something much more like Medicare Advantage. I think that would cause the greatest benefit to citizens with the least disruption and job loss. I'm sure there are some wrinkles that need to be ironed out, but that's generally my starting point.

So, UHC, then? Just with a pointless and inefficient bureaucracy bolted on, to avoid putting redundant people out of work.

 

[Emily Lake]

Why do you always have to be so hostile and nasty, Elixir? Why do you have to immediately jump to egregiously insulting insinuations?

I apologize. No promise I won’t do it again though. I’ve been battling the urge to jump to egregiously insulting insinuations since I was a teenager. There’s probably a clinical name for it, but I can’t afford a shrink.

I will try really hard to bear that in mind.

FWIW, my spouse is highly ADHD, and part of that comes with a tendency toward oppositional defiance, as well as a frequent tendency to assume the worst. It doesn't manifest in the same way, it's not necessarily assuming I have bad intentions... but it often shows up as him assuming I'm mad at him, or that I'm unhappy or angry or resentful.

It's one of those situations where my very mild tendency toward autistic traits is handy. I very, very rarely hold grudges, and my anger in one discussion doesn't often carry over to a completely different topic. There's nobody here that I dislike enough to even have on ignore. And even the people I get along with least on political topics are people I enjoy reading and interacting with in other contexts.

 

[Elixir]

it's more important for you to get your punches in so your self esteem doesn't suffer

Yes, I took it out of context. Not to distract from the context, but just to point out that an awful lot of people seem to run afoul in reading your stuff and gleaning the understanding you wish to convey, according to you.

 

[Emily Lake]

Australia buying military arms, systems, planes, etc. from the US isn't subsidizing the US.

It's certainly keeping lots of Americans employed at such boutique micro-businesses as General Dynamics and McDonnell Douglas.

Would you say that the US is "subsidizing" Australian sheep farmers, given that we import a fair bit of lamb and mutton from you?

Trade isn't subsidization. AU buying US F35s isn't subsidization, it's just trade. The subsidization is in the form of things like our aircraft carriers and submarines being out in the open ocean acting as a watchdog on behalf of our allies - of which you are a staunch one.

Look - my dad put in a ridiculous number of cameras around his house. It looks like paranoia to anyone who doesn't know him, in reality he's just tickled by the technology and the fact that he can see everywhere on his phone. It's carry over from having grown up very poor, and having spent most of his adult life being poor, and having put himself through school (with subsidization from the US Military ). But because he has so damned many cameras, he talked with the neighbors and he's got several pointed down the street and at his neighbor's front doors. He subsidizes their home security - he invested in the cameras, he pays the monitoring fees, and they benefit from his investment by not having to invest as much themselves while accruing a higher level of overall security.

The neighbor across the street is a sheriff - he subsidizes the safety of the entire neighborhood