I don't normally post these kinds of things....but I gotta ask....

 

...what is wrong with Universal Health Care? I watch CNN and CBC....all I see is a big racket about how the US President is trying to bring big government into people's lives....and death panels if you like Fox News.....

 

I went to Newport News to speak at a conference a few years back and the cabbie I got when I was on my way to the Nauticus museum to look at USS Wisconsin called me a socialist. He still didn't let up even after I pointed out how screwed he'd be if he got into an accident right now.

 

So can someone from below the 49th parallel please tell me why Universal Health Care is such a bad idea?

 

And no the cabbie didn't get a tip.

 

Later

D

I don't think there is anything fundamentally wrong with universal health care, and I expect that those who oppose it usually do so because (1) its horribly expensive, and (2) there is a strong argument to be made that it is never quite 'universal'.

I'd love to help, but London's above the 49th Parallel.

I, and (2) there is a strong argument to be made that it is never quite 'universal'.

As example, in some regions/autonomias of Spain, Social Security covers transgender surgery, but in none is covert dentist treatment, only stractions of dental pieces.

I'll try to share a few opinions from the US perspective as I see it.

 

What I don't see is a lot of opposition to universal health care in the philosophical sense.

 

The first huge block imho is the aging population and the population distribution as it stands today. The Baby Boomers are retiring.

 

What happens when you hit 65 years old here is that you can sign up for medicare (essentially federal government run healthcare). Medicare is a pretty sweet ride as it now stands so that huge block of voters won't stand for a reduction in the unsustainable benefits currently being paid. My generation cannot afford the taxes/premiums to fund medicare for our parents and grandparents (lots of them, few of us). In sum, it is currently nice to be on medicare while the program is still solvent but nobody on medicare wants to see the benefits reduced. Obviously the status quo cannot be maintained, it is not fiscally possible but if you are 75 and medicare as it stands will hold out for another 15-20 years, do you care? Of course not, you want the care at the current price (essentially free since they already paid in during their working lives). So dealing with medicare means changing benefits AND pitting current workers like me against my elders. Ugly!

 

That's enough for my first installment and I think it shows that one of the prime concerns isn't at all a bias against universal health care.

 

My next mini expose will probably be the implications of universal coverage on barely insurables like me.

Ok so from what I'm reading here, there's no opposition to UHC, just that the current status quo is ideal for the current demographic.

 

Brad is correct, it's never quite universal here. And our system [Canada] isn't 100% free either. There are certain drugs that aren't covered and they are usually pretty expensive. This is where our health insurance comes into play. Other Canadians please feel free to chime in here because I work for the Feds and they have a pretty outstanding package.

 

So if Tony is correct then what I've been seeing on TV is, generally speaking, that the loudest, most radical message gets the air time, which is why we see Sarah Palin talk about Death Panels [WTF are those anyway?] and the President gets called a Liar....?

 

Later

D

Tony's got it right as regards the news, that's for sure. I don't know how it is in Canada, but here in the US the news is far more about ratings and cash from sponsors than it is about informing the public. This is especially true since the advent of 24 hour cable news networks and the internet.

 

These are the reasons you'll see mostly extremis points of view aired and the truth is usually somewhere in the middle. It's also why anything with even a hint of sex will push everything else to the side when it comes to coverage. Hell, they're still pursuing John Edwards about some affair, even though he's basically a private citizen, and some new angle about Anna Nicole Smith's doctors making out with her has breathed new life into that tired old story.

 

I was working in the KSA for the whole Monica Lewinski thing, and the Europeans I worked with couldn't understand why Clinton's sexual antics were such a big deal. Even the Saudi's, for all their weirdness about sex, thought we went overboard on that one. Now we've got a new prime time TV show about some politician getting caught with a hooker, and how his wife copes with the situation (I watched it last night, and it's actually pretty good).

 

"Death Panels", which is supposed to be a bunch of cats who decide that a person has outlived their usefulness and should be allowed to die, are fiction. That won't make the media hesitate to play the controversy for all it's worth though. If the people suffer as a result, that's just too bad.

 

Buddha

I wouldn't say that the entire furor is about the status quo being ideal for a given demographic (even though that does play in and, of course, "if it bleeds, it leads"). Few people will say that health care isn't important (and that is backed up by poll after poll). This is just like mom, apple pie, goodness, and light and pretty much every other "good cause". When you ask about it in the abstract and without the costs/consequences/responsibilities/etc mentioned, everybody is for it. When you start talking about the brass tacks of who will do it, how they will do it, and who pays (money/time/effort) for what... That is when you get into disagreements and it doesn't require any given side to be dumb or evil for the disagreement to be strong.

 

The democrats have been selling their plan as the only way to fix the current problem. The republicans are screaming about the potential that their pet causes (eg abortion) and the weakest getting thrown under the bus.

 

The death panel thing stems from language in the bill that specifies that end of life counseling is mandated. The wording worried some folks and (IIRC) attempts to change the wording were defeated more than once (note that some of the people wanting changes had already voted for or written laws pro-counseling so it wasn't fear of the concept that people should talk to their doctors about death). As for the death panel name, it was a cute sound bite (remember that chosing the language of a public discussion is pretty key to influencing people, hence the pro-choice / pro-life monikers, etc) but the concern for that kind of issue shouldn't be dismissed out of hand. Health insurance, private or public, is about managing resources for the most effective use. Somebody somewhere does make judgements (what drugs/procedures are covered, when and how long scheduling takes, etc) in patient health care which is pretty much life and death by definition. Many people in the US, pretty stereotypically distrustful of their gov't, are concerned when the gov't steps into that role directly. After all, (in theory) you can get another insurer and their "death panel", but they frown upon you getting another gov't. (This is not to say that people don't want the health care industry regulated...)

 

The "You Lie!" part is somewhat similar. Obama says in his speech that illegal aliens won't be eligible and the plan as written says that they aren't supposed to. The republican concern is that there is no test/enforcement. So the laws says they aren't but there is no legal framework to force a check and amendments to that effect were apparently defeated. The outburst was rude and disrespectful but not really shocking as the decorum has been heading down hill for years (plenty of examples during the last presidency, they aren't hard to find in Clinton's, etc. Heck, one of the few bipartisan things Congress has done... The democrats are better rabble rousers though. And they throw better parties.)

 

I don't really subscribe to either parties' line at the moment (my position is closer to the "yes, something needs to be done and, no, there is no need for undue haste as the system is big, important, and far too costly to knee jerk") and am mostly disgusted at the way this stuff plays out via the congresscritters (watching them in interviews, townhalls, cspan, that kind of thing... Laws and sausage.). In general, I tend to give more weight to the side that proposes to do less or nothing as the burden of proof is generally on the person making the claim. Moving to a public option health care setup is a very big step and requires a large amount of convincing. You lose points for scare tactics (health care companies make great boogiemen as does the faceless gov't bureaucat) and calls for haste. So far, the US loses...

 

(As for the Clinton thing, I've always been of the opinion that it got as much traction as it did because he dragged it out and made it a soap opera. If he'd come out and just said, "Yep, I had a little intern on the side. You want to ask about the terrorists in Sudan or my personal Friday afternoon tryst?", he'd have lost some voters (which he did anyways) and made the whole thing look pretty silly. Instead we got a soap opera (only a reality tv show makes those things look good...) and attempts to parse word definitions which always plays really well for sound bites... )

ok now that I can see....the media spin thing. Up here you see alot of the same thing but it's much more subtle...very much more in fact. There is no missing it however, and you can especially see it when it comes to the sitting Prime Minister. The television media are just waiting for the chance to stick it too him and when they do, the minority won't last very long.

 

Ok back to health care.....

 

I don't know about other Canadians, but the concept of paying for health care is so foreign to me that when I think about Americans doing it, I imagine set of cash registers not unsimilar to what I see at McDonald's....I know it's not like that of course....

 

...but what happens when you can't pay?

 

Later

D

In UK, it's free to see a doctor. Also:

 

1. You do have to pay a fixed charge for prescriptions (about £7) unless you're retired or unemployed.

2. The NHS has been known not to allow certain drugs (some cancer ones mostly) to be prescribed on the grounds on the grounds of cost-effectiveness.

3. You aren't permitted to "top up" your care with private medicine, which has caused controversy.

4. The NHS will not fund optional cosmetic surgery.

5. Hospital cleanliness has been a subject of debate recently.

6. The NHS is the UK's biggest employer.

 

Remember our system was created by a government far more left-wing than Obama (but not that left-wing- it authorised the development of British nukes) and is the government providing healthcare rather than health insurance.

ok now that I can see....the media spin thing. Up here you see alot of the same thing but it's much more subtle...very much more in fact. There is no missing it however, and you can especially see it when it comes to the sitting Prime Minister. The television media are just waiting for the chance to stick it too him and when they do, the minority won't last very long.

 

Oh there is plenty of subtle manipulation (for example, the title "public option") too... But that is more for the purposes of accomplishing something as opposed to merely driving viewer ratings. Over the top brings viewers, subtle gets changes. I mean, check out TV wrestling...

 

Ok back to health care.....

 

I don't know about other Canadians, but the concept of paying for health care is so foreign to me that when I think about Americans doing it, I imagine set of cash registers not unsimilar to what I see at McDonald's....I know it's not like that of course....

 

...but what happens when you can't pay?

 

Later

D

 

Hospitals can not turn away patients who cannot pay in life threatening circumstances. This is why a common argument for the gov't makeover (toned down from takeover since that is seen as pejorative) is the fact that money can be saved by providing preventive care. There are also numerous programs to get free or reduced drugs, etc. Certainly not a position anybody wants to be in, but seldom as bad as the sides in the argument make it. Consider them the equivalent of the "they made him wait 50 years and then amputated his leg to treat his appendicitis" attacks on the various gov't schemes elsewhere.

My next mini expose will probably be the implications of universal coverage on barely insurables like me.

 

Okay, so I don't know the real implications but some things worry me and without adequate understanding I am vulnerable to fear mongering.

 

I have one harmless genetic condition that precludes me from most private insurance programs. If it hadn't been detected at an early age it could have led to organ failure and all kinds of nightmares but it was detected early and is inexpensive to manage (the Doc drains a pint of blood from me once every 3 months).

 

I have one other chronic condition (digestive system) that has meant a fair bit of expense in the past but doesn't really threaten heavy expenditure in the future.

 

The combination of those two items means very high insurance premiums but I can see my doctor and he treats me as able.

 

Universal coverage and all of the talk about results-based renumeration for doctors scares me. I have conditions that more than likely won't get better (not that they are bad). Can my doctor afford to keep me as a patient as a result? I'll most certainly drag down his scores despite him in my opinion being a practical, effective, and monetarily efficient doctor.

 

So on the one hand universal coverage means all of these insurance companies wouldn't be able to turn me down like they can now. On the other hand, would I be left seeing only inexperienced doctors who stand a good chance of harming me instead of effectively managing chronic conditions like my current doctor?

 

All of that said I have it easy. If you are a doctor that specializes in late stage cancer, do you stand a chance or are you squeezed out of your field of work?

 

mini expose done , could have been better methinks.

I don't normally post these kinds of things....but I gotta ask....

 

...what is wrong with Universal Health Care? I watch CNN and CBC....all I see is a big racket about how the US President is trying to bring big government into people's lives....and death panels if you like Fox News.....

 

I went to Newport News to speak at a conference a few years back and the cabbie I got when I was on my way to the Nauticus museum to look at USS Wisconsin called me a socialist. He still didn't let up even after I pointed out how screwed he'd be if he got into an accident right now.

 

So can someone from below the 49th parallel please tell me why Universal Health Care is such a bad idea?

 

And no the cabbie didn't get a tip.

 

Later

D

 

Here are two things that concern me.

 

1. The expense. Especially when you are already running a deficit. I don't care how they try to sell it as 'saving money' in my experience you do not get out of debt by piling on more debt. That is just assinine.

 

2. The mandate, fines and jail time. Sorry, but what we are getting is not UHC. What it will do is line the pocket of the Insurance Companies. And all the analogies to car insurance...there is one key difference, you don't have to own a car or drive, thus you don't have to buy car insurance.

 

There are plenty of people who simply can not afford to buy insurance. Many will slip thruogh the cracks because they make too much to fit the government definition of under-priveledged but live in places where the cost of living is too high to live comfortably on their income. I was one of these people in my 20s, so I fully understand why these people do not have insurance.

 

Overall, I am not against getting the uninsured insured. But there has to be a better way to achieve it that will not put people or the country in economic stress.

I wouldn't put too much stock in Fox News. I'm sure if the present administration came up with a workable solution to end world hunger, the Fox headline would be something like "Obama promoting obesity!".

 

Buddha

Here are two things that concern me.

 

1. The expense. Especially when you are already running a deficit. I don't care how they try to sell it as 'saving money' in my experience you do not get out of debt by piling on more debt. That is just assinine.

 

Different nation, different priorities. Up here we've had UHC so long that the cost really isn't in the taxpayers mind. We've always had higher taxes here because of it and that's the way life goes. I don't know if it would affect your standard of living, since we're on par.

 

2. The mandate, fines and jail time. Sorry, but what we are getting is not UHC. What it will do is line the pocket of the Insurance Companies. And all the analogies to car insurance...there is one key difference, you don't have to own a car or drive, thus you don't have to buy car insurance.

 

That's not the case in Canada. Insurance is for the supplementary items that UHC doesn't cover. Stuff like certain kinds of pills, treatments [usually experimental], and anything not certified by Health Canada [our version of the FDC]. There is no requirement for getting health insurance in Canada but there is a requirement for car insurance.

 

There are plenty of people who simply can not afford to buy insurance. Many will slip thruogh the cracks because they make too much to fit the government definition of under-priveledged but live in places where the cost of living is too high to live comfortably on their income. I was one of these people in my 20s, so I fully understand why these people do not have insurance.

 

Overall, I am not against getting the uninsured insured. But there has to be a better way to achieve it that will not put people or the country in economic stress.

 

That's part of your problem there. Requiring people to get insurance will certainly line the pockets of the insurance companies. Canadian UHC has nothing to do with insurance as it's a government run system [with a government like bureaucracy too]. I strongly suspect that 'affordable' insurance in the US will result in something that covers accidents but little else and and they will fight for that too. Insurance isn't the answer.

 

Maybe Canada, with it's smaller population [35 million] has it easy. But there is no denying a larger tax base is available for the US. I'm not saying that now is the time to do it, but I strongly suspect that the day will come when you'll have to think about it.

 

My next question on this is: What will be the end result of the US does not change the way it's health care system operates?

 

Later

D