In my area, I'm not aware of anyone who can't walk into an emergency room and expect treatment, insurance or no.  So your statement about poor people just trying to GET treatment is false.  Similarly, as Rose pointed out, pregnant women and children don't just get treatment, they get the BEST treatment in the area (I know from experience), equal to that of those who are actually paying into the system.

Why don't public hospitals offer the same salary as private ones?  Yes, for one because it would seriously increase the price.  Probably what would follow is the administrators, who are on a limited budget, would hire fewer doctors, which means we're back to people not getting service.  And when the governor comes along and says 'well, we need to free up money for my new project', public health is going to stick out like a fat, sore thumb just waiting to get cut.  So no administrator is going to want to offer fully competitive salaries if he can help it.  Remember, government run means they are NOT interested in providing the best service, in getting customer returns or whatever!  They don't follow the same rules as a private hospital.

Again, though, if emergency room treatment is all you think is needed, fair enough, the system is working.  If you think preventative medicine is also needed, then it's not.  Also, even though someone won't be turned away if they walk into the emergency room, that doesn't mean they're not hounded by the bills for the rest of their lives or don't have trouble if they need to go back again.  If you think that's how it should be (and the case can certainly be made), then the system is fine.


Government hospitals are about as interested in providing the best service as private ones.  In both cases, it's a means to an end, not a goal in-and-of itself.  The goal of private hospitals is to make money.  Anything that causes them to loose money (such as treating poor people) is something they'll do their best to avoid.  The reason government run hospitals don't provide the best service is because they haven't made that the goal.  They've made "the best we can get for X dollars" the goal.  If you make X bigger, you'll get better service.  If it's possible for the govenor to cut the budget in order to fund something else, then it's clearly not being viewed as a right, but as a luxury.  The governor can't (or at least shouldn't) get away with removing someone's right to vote because voting booths are too expensive.  They can't stop worrying about warrants just because it'd be cheaper to let the cops search whenever they want.  In order to make a system work that has health care as a right, it has to be treated as such, and currently it's not.  In order to change the system, you really have to fundamentally change it.  If people accept it being done half-way, then that's the kind of system they'll get, in health care, or anything else.  If we want a good system, it'll cost money, and it will keep costing money.  We all agree that we can't have a decent system that covers everyone and costs nothing to no one.  No one is proposing such a system (well, those of us not running for office aren't, at least).  People who are serious about health care reform, I would argue (even if I'm not sure if I agree with them), are saying "hey, this is something important.  Fundamentally important.  And we need to treat it as such.  Medicine shouldn't just be for the wealthy.  Your health shouldn't be dependent on your income.  We, as a country, have a moral obligation to provide quality health care to everyone.  Yes, it'll cost us money.  Quite a bit of money.  But so does national defense, so does running the government, so does holding elections, and any number other things.  We feel health care should be on the list of things we're willing to pay a lot of money for to make sure it gets done right."  Now, the fact that we're already paying a lot of money for the current system, and it isn't providing adequate health care for lots of people adds an interesting twist to things.  But I think it still boils down to whether people think it's something we have an obligation to do, and do right, or if it's everybody for themselves.  It's an issue of whether everyone should make a sacrifice for the good of the nation as a whole, or whether everyone should just take care of themselves.  Both sides can make reasonable arguments, I think.  But I think neither should avoid their most unpleasant points.  One said should be honest enough to say "yes, we're going to have to increase taxes to pay for this (though perhaps not by as much as you'll save by not having to buy insurance)," and the other side should be honest enough to say "Sorry poor people, this is just one more thing you don't get to have.  It's not our job to pay for your health care.  Them's the breaks."

*** Based on this, you've got my vote.

I'm with Tycho on this.

Incidentally, I didn't say they get the best..they get the only. The poor services I was talking about were for them. The rest have the emergency or private pay (think 100s for single prescriptions and 300 for doctor visits) which when you consider most don't make enough for rent, food and gas, makes going to see a doctor when the fix is reasonable almost impossible.

Personally, I would far rather pay taxes on health care for all people vs many other things (which I won't list here)..Tycho covered it well. And I too would vote for it.

Glad for your guys votes of support, but I feel I should clarify that I'm trying to express what others feel, not necessarily what I think is best myself.  I'm still not certain if I think health care is a right or a luxury, I can see arguments for it both ways.  I suppose I'm more sympathetic to the 'right' side than the 'luxury' side at the moment, but I'm still not 100% sure.  My posts have mainly been meant as a "this is what they think" thing than a "this is what I think" thing.  And of course, katisara taking one side only pushes me towards the opposite. ;)

Like I said, from my personal experience, the pregnant women got the same great service as everyone else - Shady Grove and Holy Cross are two of the best hospitals in the country for such things, and both were happy to accept that insurance, with no loss of coverage.  Same with other specialists.

Not that I'm saying we should go out of our way to deprive people of that, and certainly I think that making sure children get good medical care and education regardless as to station is important (as opposed to adults, who are now responsible for themselves), but the argument that poor (pregnant) people aren't getting good care or even the best care is patently false.

*** I think perhaps it might be more accurate to say that while not all poor people aren't getting good care, a great many (too many) aren't even getting any care (non-emergency, I mean).

Fair enough, Tycho. I tend to want to take the opposite side, regardless of what I think.

Katisara, it depends on the individual hospitals. Sometimes the best is available (especially if it is a teaching hospital), sometimes not. The three top hospitals in my old area were not available to medicaid clients. They do have to take emergencies, but for regular visits and service..not so much. A lot of it is simple cost effectiveness and public image.

Keep in mind too, that just because you are seen at the same hospital, it doesn't necessarily mean you get the same treatment. Some hospitals that take public welfare cases give them a sharply different quality of care. That isn't right, according to their oaths and such, but that doesn't make it less true.

I'm not saying that all medicaid clients get worse service than private insurance clients, but that it can (and is) often a real issue for these people.

So again though, the question does come down to whether free medical care is a right (I won't go so far as to say that medical care is a luxury.  Food is neither a right, nor a luxury, for example, nor is shelter, and I'd consider medical care in the same category as both of those.)  Or another way to put it, whose responsibility is your medical care?

There is one group of people who, unilaterally, cannot and should not be responsible for their own medical care, and that's children.  I have absolutely no problem with offering quality medical care, especially specialists and preventative care, to children.  I suspect most people will agree with that statement.  Similarly, the very seriously mentally or physically disabled would fall into this category.

However, once you're an adult, my view is that you are responsible for yourself.  No one else is responsible for giving you a house or buying you food, nor for paying your taxes or raising your children, *YOU* are responsible, you are an adult and that's part of what that encompasses.  Hence, while medical care may be a right, it's not a right that the government has to fight for you to have, it's a right the government must PERMIT you to have (so the government can't actively restrict your getting medical care).  Just like you have a right to property; the government cannot restrict you from owning property, however the government does not have to give you property.

So in that regard, I don't feel that the government has much place requiring one group of people pay for the care of another group of people.  I can understand the idea of welfare - providing a safety net while people who have paid into the system so they have time to recover (this just makes good economic sense - forcing everyone to save for a long, unanticipated period of unemployment ultimately has a very serious impact on the economy, so it ultimately pays for itself, if properly managed and distributed), but that isn't the same as saying a person who is flipping burgers should get all sorts of expensive medical treatments at the taxpayers' expense.

Related to this, I find it odd that we give so much money to old people.  Didn't these old people have their whole lives to save up for being old?  It's not like it crept up on them, or that young twenty-year-olds are surprised one morning by being 60 years older.  What are these people putting back into the system?  Does it make sense to say 'this person has a right to health care, ergo the government should pay $20k a day to keep his machines running', or even simpler, 'the people should pay $2k a week to buy this old person medicine'.  I don't mean to sound harsh, but we get old and die for a good reason.  Is it prudent to invest so much of our time and energy elongated the lives of people who have both had a time to invest this energy themselves when they were young, and won't provide anything back to society?  What good is this?  Who does it benefit, except the doctors?

My opinion is that it is the government's responsibility to provide health care. It's not as if the government shies away from legislating in our lives, and as taxpayers for all sorts of things, it only makes sense that part of our money goes to pay for our health care. This is the stance that most western societies have taken and it seems to be a sensible one.

The idea that children should recieve care if needed is the primary motivation for the subsized medical that exists. That's why eligibility is so limited. Part of the reason I'm in favor of government provided health care is that the children need healthy parents to provide and care for them. And for single adults, well, how can we fairly argue that just because you breed you automatically deserve better health care than someone who hasn't? I also think that economically, it is more sensible to pay for cheaper preventative and minor care than wait til the illness is so severe that it requires emergency treatment.

As for the older people, most programs that assist them are social security and medicare (of which I'm certainly no expert)  but as far as the 'welfare' system goes they receive help paying premiums generally, and the maximum check they can recieve is about 500 a month, and this is expected to pay for food, shelter, medical, gas..ect. Not exactly a princely living.

As to why? Seeing someone helpless and in an untenable situation makes others want to help that. It kind of is a side of human nature. Not a bad one, I might note. Add to that a growing subculture of people who lived life beyond their means, were unable to save and have enough organization to influence voting trends and you have your assistance. Good enough reason for them to get the perks? I don't think so. Would I change it? No, because I had grandparents and I'd have wanted them cared for if I couldn't do it.

And this is precisely why I oppose socialized health care.

"The government steps all over our rights everywhere else, so we might as well get SOMETHING good out of it!"  Absolutely not.  How about, instead of making deals with the devil, we tell the government to butt out, and start pushing back against that inappropriate legislation rather than rolling over for it?



Sick, aged and disabled parents have been doing an excellent job caring for their children since basically the beginning of time.  I really can't see this argument holding much water.



I agree with this, but this firstly doesn't tell me whether it's better to pay for preventative medicine or to pull back emergency room services, and secondly doesn't encourage me (as the administrator) to support any sort of 'general care' that isn't preventative.  I'll pay for you to have your teeth fixed, but not for glasses, because poor eyesight doesn't generally result in any sort of worse medical development.  I also won't pay for your degenerative disease for the same reason, the cost outweighs the benefits.



The maximum check I expect to receive when I retire is on the order of $70k/year, but that's because I plan ahead.



Then let people help!  We have plenty of charity organizations that offer this sort of support, voluntarily and efficiently.  This isn't the government's business, to save us from ourselves.  Freedom means having the right to fail.



Your parents didn't work, earn a retirement, put money in savings?  All of mine did - or they kept working when others did retire.  Unless there was some reason they physically couldn't work, I don't see a lot of reason to justify the 'well, you bought a luxury car and now have no money for medication, let me help you out' mindset.  Saying they control a large voting block isn't an excuse, if anything it's more argument to fight back.  If we let Rome belong to the circus, the whole empire will fall.

I think this sort of gets back to the liberal/conservative mindset thing I brought up a while back.  Liberals are thinking in this case "there are people not getting adequate health care.  What can we do to help them" and conservatives are thinking more along the lines of "who's abusing the system and how to do we stop people from getting a free ride."  It's the issue of what's the lesser evil: letting people go without health care, or someone getting health care they may not 'deserve.'  Both sides, I would say, want everyone to work hard and earn adequate coverage.  Given that that ideal situation isn't likely to happen, there are two ways to approximate it:  give everyone adequate health care, even if they're not working hard, OR only give it to people who can afford it (also whether they've earned it or not).  The first tries to avoid letting anyone go without, the latter tries to make sure everyone works.  Both sides have merit, though I'm more sympathetic in general to the help everyone and tolerate the freeloaders side.

The trouble, I think, is that we don't really live in a pure meritocracy.  Being rich doesn't actually imply you've worked harder than someone who's poor, nor does it mean you've planned better, are smarter, or anything else.  If you've got rich parents, like as not you're going to end up rich yourself, regardless of how good at planning you are or how much effort you put into getting rich.  If everyone started equal, and their wealth really were based mostly on how hard you work, or how efficient you are, or whatever, then the "it's your responsibility, no one's going to do it for you" arguments would have more strength, I think.  If we consider it okay for children of rich people to get luxuries they didn't earn, then I don't see why we should be so worried if poor people do.

Another way of looking at it, is that how society treats the helpless says a lot about the society, even if the helpless people are that way because of their own decisions.  It's sort of like the parable of the prodigal son.  Was the father in the story wrong to welcome his son back?  Should he have said "sorry, son.  You got your share already, and you blew it?"  Should we, as a society, emulate the father in the story?

You oppose health care because we already pay for other things? I think less that we should get something from our government and more that the government owes its citizenry a certain amount of return on their investments.

Strictly speaking, glasses would afford a more competant worker, so I would say that it ought to be included. The degenerative disease, unless a case can be made that there is a full recovery available, I can see your point. I don't agree, but its certainly valid as an argument. And beyond preventative, there are minor illnesses such as colds and flu or infections that can be easily cured but can develop into things like pneumonia, ect. I think that would be a fairly valid case for general care.

And it isn't about not working, its about wages being too low to do more than subsist on what they make. I read (and no, I don't remember where) that most people are two paychecks away from poverty. That's a lot of people who might want to save, but lack the means. Beyond that statement I really ought to take it to the education/career thread or someplace more appropriate.

I think you misrepresent the conservative cause.  I do understand some people get a 'free ride'.  I spent four years in Venezuela, surrounded by the children of oil barons, who were born into absolute wealth, while surrounded by abject poverty.

Rather, the problem is people shirking their responsibilities, or more importantly, shirking them on to me.  If somebody came up to me and said 'hey man, can I borrow a dollar', I'd probably give him a dollar (well, not really, I've taken to carrying oranges or bananas I'll give away, now that I work downtown, but you get the idea).  Whereas if the guy comes up and says 'hey man, you owe me a dollar', well that's a different matter.  It's a question of entitlement.  I don't mind people being allowed to have care, allowed to have more than they deserve, by the goodwill of others.  But that isn't the same as my being required, by threat of incarceration, to give to others.  That is a violation of my freedoms, under the guise of charity, but it's certainly no charity if I have a gun to my head (and I literally do have a gun to my head, because if I don't pay up, people with guns will come to my house and drag me off).

That is what I object to.

Maybe I do. I'm not conservative, more the bleeding heart liberal (if you couldn't tell), and if I was inappropriate it wasn't intentional. I've never been great at debating things, which is generally why I simply read.

Fundementally I agree that no one should be forced to be charitable, since that essentially negates the meaning. I don't think individuals as a rule should be responsible for the caring of others; I believe that government as an organization would function better if it provided for its society as part of its budget. Given the economy in which we live and the availability of jobs, credit and all those money issues, more people than not need the help. In best case, everyone would be capable of caring for themselves, but I think most people have proven they just can't. For whatever reason, good or bad. It isn't that we don't pay enough as taxpayers, I just think the budget needs to be reworked to include health care. From my perspective, it is part of what a government should do, take care of its people. It's a form of a safety net, just enlarged from the very minimal that currently exists.

That's fair enough, and it's a valid argument.  But again, you're stating your argument in a "what's it costing me?" frame.  I really am not trying to misrepresent the conservative view, but it really sounds like "shirking responsibility" is the same as "getting a free ride" to me.  It really sounds like "it's violating my rights" means you're thinking about yourself in this case, whereas people in favor of the health care reform are thinking about how it will benefit others.

To put another spin on it, you view government health care as someone coming up to you and saying "you owe me a dollar," so you don't like it.  People in favor of it view it as "will my dollar make this country a better place," so do like it.  Both views are valid, and can be argued.  But it's that difference in mindset that leads to the difference of opinion.  It sounds like socialized health care, in your mind, is the government taking your money against your will and giving it to someone who is shirking their responsibility.  To others, in their mind, it's a way to help people who need help, and thus make the country better overall.  Both can be right at the same time.  It could be both of those things.  The difference is just the points that are focussed on by each side.    I'm not trying to say the conservative side is bad, or wrong, just that it views things from a different angle, which is often the "why should I have to help that guy?" angle.

No, I don't support paying for that because it supports a mindset I am fundamentally opposed to, that of decreasing our individual freedoms and trading them in for inconsequential comforts.



So can a college education, a car, a wife, an apartment, a stack of suits, leisure time, vacations, massages and so on.  Should the government provide those too?

If a person decides he's going to get a better job and requires glasses to do that, there are plenty of methods to get the $400 that don't require it being given away to him.



In most cases, I would disagree with that.  Firstly, there really isn't any cure for the common cold.  Pouring anti-biotics and the like into people to cure minor ailments is also poor practice in general because it breeds resistance.  Of course, if you have risk factors, it's a different matter.



Why are they two paychecks away from poverty?  Is it because their paycheck is so low, or because they've spent too much on their credit card, spend too much month-to-month on cable TV and car payments?  The average US citizen has one of the highest standards of living, as measured in just stuff, as well as the highest accumulation of debt.  We live in a material world where we're taught it's okay to go in debt to get nice things.  Maybe we should stop supporting that behavior now, before it blows up in our faces.



Do you see how these two sentences contradict each other?  The government is FOR and OF the people.  You can't say the government is responsible for caring for people without, by extension, saying these bunch of individuals are responsible for that as well (unless you're planning on getting some other government to care for those people.  I certainly wouldn't object to Canada's health plan if, by that, we meant Canadian tax payers supporting Americans getting health insurance.)



I again, I disagree.  I would say more people WANT the help than not, but that isn't the same as need.  If more people stopped living beyond their means, they would stop finding themselves in mountains of debt.



It's more of a question of justice.  If the government came up to my next door neighbor and said he had to pay more taxes because he's homosexual (just to throw out an example), I'd complain, not because I benefit from complaining, but because it seems like it's an injustice.  I don't support big government, and socialized health care is making it bigger, much bigger.  Big government is a threat, and it's unfair to those, all of those, who prefer government not meddle in their affairs, for better or for worse.

If liberals in general feel they need to help other people, why don't they start donating more, voluntarily, to causes which do that, rather than force others to support their agenda?  Isn't that contrary to freedom, to respecting other opinions, by saying 'you will put money into this program I think is right, or police will break down your door and drag you to jail'?  I fail to see how socialized medicine is in any way 'liberal'.  In fact, to the contrary, it seems downright fascist.

Is there any part of government that can't be viewed this way, though?  Is government run police 'facist?'  Government run fire departments?  Energy providers?  Navy?  Postal systems?  You are force, at gun point as you put it, to pay for all of these.  Are you opposed to government in general, or just "big" government?  What's the difference between big government, and necessary government?  Perhaps the point of disagreement?

Also, I think the examples you give again point out the difference in mind set.  There are some people who can't afford health care because they overspend, aren't good with their money, abuse credit cards, or whatever.  There are also people who can't afford health care because they had previous health problems, and work at a minimum wage job as a single parent raising two kids.  They're going to night school, and they're doing all they can to work they're way up the ladder, but they're not yet at a point where they can afford insurance.  The liberal mind set is that these people should be able to get help, even if means the former people get it too.  The conservative mindset seems to be the latter shouldn't get help if it means helping the former.  There seems to be this assumption of dishonesty by conservatives of anyone in a bad situation.  If they're poor, it must be because they're irresponsible.  Conservatives tend to speak about people getting away with bad behavior in this type of thing, and liberals tend to speak about the people who are doing things right but still need help.  Again, it seems to be a difference of opinion on what's the worse evil.

I wouldn't go so far as to say they are all fascist, since the cost of most of these are almost negligible.

I believe that the federal government exists to serve one purpose; protecting the rights of the people.  That's it, that is its sole charter.  It may offer services to people as well, but it's PURPOSE is to protect the rights of those people.  There is a necessary cost for this, which we currently get through taxes.  Services designed to protect the freedom of people are, of course, legitimate.  Of the list you put up, that would be the Navy (and debatably, the police, but the Federal police only have a very limited number of duties, and most people are unlikely to even see one in their lifetimes).

Postal service is just that, a useful service.  It provides a very clear cost and benefit, and the benefit for each person well outweighs the cost.  The cost to the taxpayers for the postal system has always been almost negligible, but the benefits have been tremendous.  If that ceased to be the case, the postal system should be dropped (and we may be approaching that day soon).

Fire department, municipal police and the like should be run at the local level, coincidentally, just like they are.  In general, things should be run at the lowest level possible, to offer the greatest control and benefits to the people.  The postal service really can't be run at the state level, so it should be federal.

If a state wants to set up its own health care system, they can do that - and I can just move out of that state (or move into it if I'm poor and in need of care).  But for the federal government to do so, you'd have to prove to me:
1)  It increases or protects my freedoms
If 1 is not met:
2)  It does not curtail my freedoms
If 2 IS met:
3)  Its benefits to people on the whole outweigh its costs

I don't see that as being the case.



Shouldn't these people be able to get some sort of a protected loan, rather than a gift?  Isn't that half the point of the current, federally backed student loans?  Those loans make sense - they're an investment, with clear benefits to society, and with minimal cost.  Giving money for free to students would not make sense.  That's what we're doing with health care - giving it for free on the assumption that people won't abuse it, and might pay some of that value back.




Again, that's a mischaracterization.  I don't believe poor people are bad or stupid.  But I do believe they're responsible for their own lives.  And I certainly believe there are systems which encourage abuse, and systems which encourage proper investment.  Giving something away for free encourages abuse, so let's avoid that if we can.  Giving necessities away for free to people of working age discourages them from working, so let's avoid doing that too.  This isn't saying that a person who gets free stuff won't work or is corrupt, but it does mean that, statistically, we will have more problems if we operate that way.  I don't think saying 'this system is inefficient' is equal to saying 'damn those who are in need, it's my money'.

It seems Katisara advocates some kind of victim-blaming rationalization. That all poor people are poor because they aren't responsible enough with their money. That they brought it on themselves. At least, that's the impression I'm getting.

I can understand from a philosophical point why conservatives oppose socialist healthcare. Socialism is like the boogy man, they have nightmares about sharing with people, I get it. But I can't understand why any conservative, especially fiscal conservatives, would support our current system. It makes no sense from a fiscal standpoint. We're throwing so much money into it, so much more than the other developed nations, and getting so little out of it. Say what you want about socialism wasting money, but we actually pay per capita (that's per person) about twice as much as socialist France does for their system, and yet they still have a much greater reputation for these things. And say what you will about credit card spending and people buying more than they need, but the number one cause of bankruptcy in the states isn't maxed out credit, but medical bills. And, strangely enough, many, if not most, of the people who go bankrupt on medical bills have health insurance.

I think that sums up a lot of the problem right there. Most people have health insurance, but it isn't doing much for them. They still go into bankruptcy from medical bills, and they still aren't getting what they need. Hell, most accountants won't even look at you funny if you told them that it was medical bills that sent you into bankruptcy. It's so common, and so out of the peron's hands that most of the time, they aren't even held accountable. Sounds like they brought it on themselves, right Kati?

We're going through this right now, in fact. My mom early in the ear survived from a major car crash that most experts say should had cost her her life. Drunk driver smashed into her car, causing her to hit a tree and the car to literally flip over on it's head. She suffered spinal damage, major damage on the third  fourth, and fifth cervical vertibrae, she was put into a halo after the operation, and started physical therapy after they discovered things were going fine. Within three days, she could make it to her feet and walk even a short distance. The minute the insurance company heard that she could walk, they ordered her home, concluding that she no longer needed the care. She was miserable around the home, but she survived. However, concluding that the injury must not have been that severe, they kept witholding regular treatments, and sending her to general practicianers to assist with her needs. They never even had a case manager for her. They'd set up a recovery plan alright, but everyone they sent her to didn't do the kind of treatment she needed (literally, from their own words, we can't help you). At the same time, the company demanded she move on to the next step, even though they never even secured her a specialist in the first place. The only specialist they sent her to early on that could help her she had to stop going to, because her iinsurance no longer was covered with that particular office.

Just yesterday, my mother had another operation. It seems that the third and fifth vertibrae were recovering just fine, but the fourth hadn't made an progress since she left hospital care months ago. In addition, because her halo never got readjusted throug the process, it was malaligned. She literally was bleeding from the holes in her head. The week before, she was in agnoizing pain constantly, so much so that her vision was literally going. She tried going into emergency, but seeing as the insurance wouldn't pay for it the necessary tests and treatments, and it wasn't seen as life threatening, all they did was put her on some painkillers and sent her on her way. They refused to even wipe the blood from her holes. She returned later, and they did the same thing, this time delivering with her a written note saying not to come back without her practiioner's written aknowledgement of need for serious treatment. They had guards, armed hospital security, escort her out the building, a woman bleeding from the head that should hardly walk. We eventually took her to another hospital, roughtly half an hour's drive away. Had the first hospital simply done an x-ray, it would had been obvious that she needed help. The doctors there said that the next hit to her spine, even just against a wall, could had risked permanent paralysis. They arranged for surgery just within 24 hours of the test results.

Here's the screwed up part: She has medical insurance, and not bottom of the line stuff, good health insurance. These weren't some overpopulated, run down hospitals either. There were rarely waiting lines. They are good, accreditated hosptials. And even she can't get what she needs. And of course, that hasn't stopped the insurance company from forwarding every bill they possibly can in our direction. Did the insurance company provide the necessities? Yes, they provided the operation that saved her life. Did they ensure much more than that? Not if they could find an excuse not to. It was like the company was hoping, seriously hoping to the point of delusion, that her injuries weren't serious, that it was all a passing thing.

We give too much power to people who aren't interested in helping us, but making a buck. And it's not hleping our economy in the slightest. It's only helping the health industry. It's shoddy, and completely inefficient, which is why I can't understand a conservative supporting it. Katisara constantly rants on the inefficiency of various governmental programs, yet adamantly supports this one, despite that it's exactly every bit what he's ranting against. Why? Because it's not socialist? Are you guys really so willing to cut your nose t spite your face? Is it really the point?

If you don't want a socialist health care system, that's fine. I'm not even all that adamant about it being socialist. I just want something that works, and what we have isn't working.

But isn't such attitude exactly what makes US health care, education and welfare systems as abysmal as they are?

I will respond to Vexen's (primarily incorrect) post when I get back.  To respond to this, the problem is that whenever the subject comes up, the two sides of Congress get so caught up in how much additional coverage is offered, that neither can get together to actually fix the system even at the level of coverage it's offering.  Both sides agree the current system is inefficient, but both have so many agendas they can't get past to work on what's here NOW, nothing gets done.

And that's a legitimate position.  But it's not the only possible or reasonable position.  Some people believe the government should make the country a better place to live as well, improve the standard of living, etc.


Just for clarification, is to 2 or 3 that you think fails?



If you think a student loan will cover major medical costs, I you're confused about what they're for and what you can do with them.  Is a loan better than a gift?  In many cases, but not all.  If someone's in a car accident, does it really benefit the country if they have to forgo, say, night school in order to pay off their doctor bills?

And the last sentence is slightly in accurate.  It's not that we're assuming people won't abuse it.  We accept that some people will abuse it.  But we consider some amount of abuse an acceptable price to pay in exchange for people getting adequate health care.  Again, it's the lesser evil issue.





I know you don't believe it, but all your arguments seem to carry this kind of tacit assumption.  Its sort of like Bart's "do poor people have poor habits" question in the other thread.  Even though it's not what you really think, it comes off that way because the arguments are always "why should I pay for them" or "they're responsible for their own place in life" and the like.  Your arguments don't seem to accurately represent your feelings on this.


Again, this sounds great, if it's applied across the board.  But conservatives are only happy to apply it to poor people.  Bring up the estate tax, and trying to take away just some of a huge handout, and they get up in arms.  Like I said before, conservatives don't seem to be opposed to handouts, they just want to be able to pick who gets them.  It's okay for rich kids to get something for free, and for them not to work, but it's not okay for a poor person to get health care if they can't afford it.


Can you show that we'll have more problems if we operate "that way?"  Is that an assumption, is that documented?  And how are you defining "problems?"  Are you just looking at cases of people abusing the system, or are you also including people who can't get adequate health care despite doing all the right things as a problem?

I think Vexen's example illustrates an important point.  Insurance companies are only efficient at making money for shareholders, not at providing good health care.  Insurance companies spend much of their money on effort in trying to get someone else to pay for health care, or on screening out unhealthy people and not offering them insurance.  The insurance companies are a major inefficiency in the system, in terms of getting health care to people at a low price.

I was thinking about Vexen's story about her mom today (out of curiousity, Vexen, is your mom on state farm insurance?), and had a thought I thought I'd bounce off you guys to see if you agree:

One of the problems with the insurance industry, is that unlike other companies, they don't want repeat business from people who use their service.  In most businesses, the idea is that if you don't provide a good service, the customers won't come back, and you'll lose money by not getting that repeat business.  Insurance companies, though, would rather get rid of all the customers that actually use their service (ie, people who get ill), and keep only those people who pay for it but don't use it (ie, healthy people).  They're happy to treat you great while you're healthy and just sending in checks every month.  But once you actually need to get money for them, you're costing them money rather than earning them money, and they'd much rather be rid of you as a customer.  If you need a doctor now, you're all the more likely to need one later.  So there's not that incentive to provide a good service.  The threat of you leaving and going to another insurance company doesn't work, because they'd actually prefer that you do so.  They've already got some money out of you, and any further money they get from you is likely to be offset by money they have to pay for your health care, so driving you away isn't actually a bad thing from their perspective.  I've heard stories similar to Vexen's a number of times, not just in health insurance cases.  Once you actually try to get a large some of money from insurance companies, they seem to fight you every step of the way.  Small things they're happy to pay for, because they're still coming out ahead, and by paying the small stuff they're less likely to have to pay for something big in the future.  But the big stuff is why people actually have insurance.

So my question to you guys is this:  Where is the motivation for insurance companies to treat their customers well, and provide high quality health care, in cases when the customer is actually costing them money?  Isn't a private insurance company's goal in direct conflict with the customer's goals, in that the company wants to avoid paying the customer more than the customer pays them, but the customer buys insurance for just such situations?  Does an insurance company have any motivation to treat a customer well once they've become a net loss of money?

Vexen, I don't know if you actually read my posts.  If I'm reading you correctly, however, you are prejudiced against people holding this position, and there's little I can say to change your mind.

I've never said that all poor people aren't responsible with their money.  I've never said the current system is any good, either.  What I'm saying is that moving the responsibility to the government is a poor idea, and will result in people like your mother (I do hope she starts getting the care she needs, of course) still suffering, just from a different set of problems.  Instead of only getting the care she 'needs', but getting quality treatment in those cases, she'd get all the appointments she needs, but shabby care in every instance, assuming she can get the appointments at all.  I suspect your mother would complain just as much (and rightly so) if she was told she'd have to wait 9 months for her next check-up.  She might as well not have an appointment at all at that rate.




Then I recommend those people move to a country where the constitution or charter there supports that.  They quite outnumber those like the US.  Or, alternatively, they can move to a state that supports that, since that's the idea behind the system we have now.  Maryland seems to feel similarly, the government should improve your standard of living.  West Virginia seems to be a lot mroe hands off.  So if you want that sort of service, move to Maryland.  If you don't, move to West Virginia.  That way we can both be happy (and, coincidentally, tolerant).  I don't feel this current mindset of 'well they do it there so we should do it here too' is tolerant, in that it means that people like me who think the way they do it there have no where to live.  There is no nation in the world, with the possible exception of New Zealand, from what I've read, which embraces independence, freedom and personal responsibility as much as the US.  What am I supposed to do, fly to the moon?



I think the proposed system fails at number 2, because its financial cost is simply too high, and that impacts the freedoms of whoever is paying that cost, and number 3 fails because the likely costs, financially and the human factor, will outweigh the benefits.  It isn't the best solution.




That's not what I'm saying.  I'm saying we currently have student loans available, primarily through the federal government.  Why don't we have medical loans?  All in all, they oftentimes cost about the same, they both are required to allow people to become productive.  Imagine a system where you apply for a loan with a fixed rate barely above inflation, and you don't have to pay it back for say four years after you take it out.



If the person is in night school, and is suffering as much as Vexen's mom is, she's not going to night school any more.

And ultimately, there's nothing stopping you from taking two loans.  You'll be working very hard, but no one said there isn't a lot of work involved with life.  Worst case, you default on the loan, the government is back to where it was if it had given you the medical care for free, and you 'pay' for it by the difficulties involved with bankrupcy (which is where you would have been anyway if you hadn't accepted the loan - except now you went bankrupt AFTER all your medical care is taken care of).  Everyone comes out better than they would have otherwise, but no one gets a complete free ride.  It's cooperation.



I will say, I believe that most people can get out of poverty if they're willing to sacrifice.  If they're willing to pull two jobs, to forego cable television and vacations, to put off children, you can do it.  There have been experiments to show this, where people with no credentials and no money pulled themselves up by their bootstraps by their own hard work.  And ultimately, THAT is the American Dream, that any person can advance (or drop).  There are exceptions, and sometimes you do everything right and just get a bad roll of the dice.  But ultimately, how many poor people do you know who work 12 or 16 hours, who sit down and manage their budgets, who cut luxury spending?  Until you've made that sacrifice, and kept making it continually for years, you, as a poor person, have little right to complain the system isn't fair.



That's because that's the government telling me I can't give my money to who I want, it's telling me I can't build something for my children.  I personally don't have much feelings on the estate tax one way or another, but I think there's merit to my saying the government has no right to stand between me and preparing for my children.



It would be almost impossible to statistically show such a thing, as well you know.  We're talking about economics, there's no statistical proof for even things we accept as givens (like spending more money leads to inflation).  If we had a way to test how many people are taking advantage of the system, or aren't working because they're getting free stuff, then we'd know precisely who to take off of it, wouldn't we?  When we are talking about economics, we need to build off of logical statements.  I think it's a reasonable logical statement to say that if a person can get something for free, he's unlikely to work for it, however if someone is told to pay for someone else who isn't working, he's likely to despise that, and will work to get out of that relationship, that if a person's work isn't judged by its quality, he will have no incentive to provide quality work.



The current system doesn't work because it's not open to market pressures.  How would *I* fix it?

1)  Standardize terminology and plans, make it easy to understand.  Do you know what a PPP is or what the alternative plan is?  Because I don't.  As a buyer, this stuff is too confusing.  That needs to be eliminated.  Standard, common-sense terminology as a requirement, just like we require ingredients on our food.
2)  Require a standardized statement of benefits and how you receive them, again, like we put our ingredients on your food.

Now you know what you're buying, and you can compare one plan to another without spending a full day doing it.

3)  Reduce barriers to entering the market.  The more plans we have competing, the more pressure the plans will have to play according to the rules.
4)  Make it easy to sign up for health insurance.  For instance, require that health insurance plans be able to give you a sign-on quote over the phone or internet, and that they can't alter it by more than 10% either direction, excepting if you withheld information (sort of like how auto mechanics work).  This allows you to investigate multiple companies over a short time.
5)  Promote ratings systems.  Allow customers to express their pleasure or dissatisfaction.  Focus especially on those like Vexen's mother.  This is the absolutely critical part.  If Green Cross Insurance throws out all its customers, this needs to be publicized.  Perhaps require these ratings be sent with the price quote.
6) (Optional) Take two of these private companies, set up a plan to cover preventative medicine and emergency room care (or whatever is appropriate), and say the government is footing the bill for each person who signs up.  This is your public health care.
7) (Optional) Create a government-run system that people pay into normally.  This creates a baseline against which everyone else must compete.  No one will do worse overall than this or they'll go out of business.

Now you have a diversity of plans, some offer bare-bones, only medical emergencies, some offer terrible service, but at a great cost, some offer terrific service but are very expensive.  But ultimately, when I'm signing up, I'm signing up knowing exatly what sort of service I can expect.  If I'm looking for good service, the company must get its current customers to agree that the service I'm offering is good in order to win my business.  This takes the focus off repeat business, and puts it on new customers, which is what the insurance company is really greated towards.