I personally wouldn't have much problem if it was handled at the state level, though it'd likely be less efficient to have X variations of it, and complications such as people living in a state with universal health care vacationing in a state without and needing an immediate hospital visit.  Not an insurmountable problem, but it'd be a bit more complicated.  Like I said, I'd be okay with that.  My question, though, is does the argument really change just because it's at state level?  What if all 50 states adopted that system independently, would you then feel it's okay?  Is it not okay for a government to do 'X' if there's not somewhere that you could moved to that offers 'not X'?  The point about the constitution is valid, but what if the people elect officials who make an amendment that specifically lets them set up a health care system?  Would that be acceptable?


Okay, what cost/benefit level would be acceptable to you?  And what level of costs would be acceptable to you in terms of passing the infringing freedoms test?  Just looking for ball park figures here, as clearly anything more specific would be pure speculation.  For example, I assume you'd be okay with if it everyone got free, high-quality health care, and it cost each tax payer 10 dollars a year.  But probably wouldn't support it if it cost everyone $20k a year.  Where's a suitable tipping point?  $1000/year on average?  $100?  $2000?  $5000?  Roughly speaking, what would cost would be acceptable?


I wouldn't be opposed to such a system.  I don't think it's a cure-all, but I don't have any objection to it.  Out of curiosity, do you consider government-backed student loans to be a violation of your freedoms, since it's costing you tax money for the government to provide them?  Do you consider it a violation of the consitution?



Perhaps, but surely you can imagine cases where a person suffers an injury through no fault of their own which costs lots of money to treat, and could be forced to choose between paying off their loan, or getting an education or otherwise improving their ability to contribute to the economy.


Well, in many cases there is something stopping people from taking out more loans.  People don't like to loan money to people that aren't likely to pay it back.  I'm also pretty sure that even if you go bankrupt, you don't get out of your federal student loans.  If I recall correctly, the student loans I got also required a co-signer, so even if I went bankrupt, whoever cosigned for me was still on the hook for them.  Those might not have been the federal ones, though, I don't recall perfectly.




Which is fair enough, but it's still at odds with the "no hands outs" ideology that is used to argue against these programs.  Like I said, it's not an opposition to hand outs, it's just wanting to pick who gets them.  You're okay with people getting hand outs, you just don't want to be forced to give them.  I'm not trying to say that's not a legitimate position, I just wish people who hold it would make it more clear that that's their position, rather than focussing on the "no free rides!" aspect.  Like I said before, it really comes down to a "don't take what's mine" position, which is a legitimate position, but it's often portrayed as something else, such as a "no handouts" position or a "you have to earn it" position, which clearly really isn't the motivator of people who fight to be able to give their kids huge handouts.


The thing is, though, you get other things from working.  Very, very few people are content with the bear minimum, and will work to get more, even if they're given something for free.  No matter how much people have, they tend to want more, and very much don't want to have to settle for less.  These, I would argue, are the real motivators for work.  It's not just about meeting your basic needs, it's about getting more than you currently have. The last sentence above I'm a bit confused about.  What part of the system wouldn't be judged by it's quality?  I don't think anyone is opposed to merit-based pay for doctors, even within a univeral coverage scheme.



Sounds good by me.


These work for me too, though the major barrier to entering the market, I would say, is the huge amount of capital needed.  I'm not sure how to fix that problem.


Why keep the middle man of the insurance companies in this case?  Why not send the bills direct to the government?  What are the insurance companies adding in this situation?


This works for me, but it's still a "health care is a luxury" model, since people who can't afford it, won't get it.


I'm all for the more information angle.

I think it highly unlikely that all 50 states would adopt such a plan, however it's quite reasonable that all the states I'd care to live in would.  I currently live in such a state, however, and my arguments against the local plan are very different than those against the federal level (mostly about effective administration, rather than whether the system should exist at all.  I already accept I've been outvoted.  Maybe one day I'll vote with my feet, maybe not.)

However, yes, I think it would be rather unjust to remove any option for people who don't feel they want to be part of such a scheme.



I think we can agree there have been amendments that contradict the Bill of Rights and so on.  Just because it's added to the Constitution doesn't mean it's constitutional (in the spirit of things, obviously it literally is).  If they added an amendment saying all people will have 666 stamped on their foreheads, I wouldn't accept that either.



If it cost EVERY tax payer something?  Well that steals some of my thunder, because we know under the current system some tax payers pay a lot more than others.

Ultimately though, we can reduce this to basic finances.  Odds of needing such care * value of such care gives us a precise number.  On the flip side, we have the cost 'per' taxpayer.  If it were a flat tax, this would give us a clear cost/benefit analysis, and we could say for certain 'well, it costs $1,000 to get into the system, but it's effectively saving you $1,500'.  That would make sense.  However, it'll be a progressive (code word for socialist ;P) tax, so some people will be paying $0, and some people will be paying $20,000, but everyone would be getting $1,500 of value from it.  At that point it starts to be a little unfair, and how unfair depends on how much pressure is put on people.  If we have one guy responsible for paying $10M, and everyone else pays $1, that's unfair even though I'm probably not that one guy.  Saying he's rich and therefore he can spare it isn't a valid argument.  Someone may have a lot of kids, but that doesn't mean he has any extra, or he may have a big house but he won't appreciate your letting random people sleep in one of his bedrooms.

How do we calculate the cost to these people?  That's pretty tough.  How do we translate the value of $1,000 to someone who earns $55k/year to the value of $1,000 to someone who earns $550k/year?  If we figured that out, we'd have a method of determining what's a good value.



No, because the government makes the money back with interest, so no money is really lost, nor, hopefully, is any gained.  On the books, in theory, it would be a zero, almost zero cost (only the cost of administration), but it has a clear benefit.



Depends on how the seed money is acquired.  It isn't a service that's explicitly supported by the constitution, but I don't think it's explicitly disallowed either.



Assuming we have a character who simultaneously is of limited income, suffers an injury through no fault of his own, but is unable to find legal recourse for such a thing, didn't have the foresight for appropriate insurance, or the insurance cheated him somehow or isn't providing services, the fellow is honestly trying to better himself through education and doesn't qualify for any other form of financial aid, loans from family, etc. then yes, this person is the unlucky fringe case who owes a lot of money.  But at least he has reasonable options, can still make a difference, and maybe he can't afford night school now, but in six or eight years, he can take a whack at it again.  No one said life is fair, and it's certainly not easy.

At the same time, I think someone who did go through that would have proven he has a lot of very hireable qualities (assuming he's not majoring in Greek or something, which sort of makes him not very hireable any more.  Do we actually offer federal student loans for Greek majors?)



That's why the federal government offers them.  What does a college freshman possibly have that would make a private business interested in offering him a loan?  Generally nothing.  That's what Fannie Mae is for.



My wife had a fannie mae loan (which we paid off, so I don't remember any of that).  No idea about the co-signer either.  Although in truth, a person who has no money has no money.  There's really no other way out of it.  The gummint isn't going to throw you in jail (or shouldn't, under what I'm suggesting) for that because there's no benefit for that.  If the federal government does feel repayment is absolutely necessary, it seems the best idea would be to require 'community service' - either as a normal federal employee getting some of his pay docked (or not), or doing some other good work for the community.  If the guy can't get a job anyway, that's a plus for him, a plus for me, the taxpayer, a plus for the government.



Let me say, I don't think anyone is against the government giving out hand-outs per se.  What they're against is the government using taxpayer money to give out hand-outs.  So it isn't that conservatives want to limit who gives hand-outs, but rather, who is required to pay for them.  If they're paying for them, they want a say in that.  I think that's fair.  Your phraseology is like how Heath (I believe it's Heath) made some statement about liberals wanting more taxes, and you corrected him saying that's not their goal, but how they do it.  Conservatives don't want to stop hand-outs, but they want control over their money.  If congress-people set up their own hand-outs from their salary using the gov't as a vehicle, no one would complain.

So it's not even 'don't take what's mine' but, if you must take what's mine, I want a say in how it's used, and I want to make sure it's used appropriately.



You did go to college, right?  Did you live on campus?  Meet college students?  Who was more productive, those who were paying their own way in loans or out of pocket, or those who were getting their tuition paid by someone else?  Which group was more likely to get a job and which was more likely to play beer pong?

In my experience, that group is definitely not 'very, very few', it's a significant number which gets larger every year.

Heck, just speaking for myself, basically my entire paycheck goes into shelter, food, clothes, medical costs, costs associated with going to work and soon will include education costs for my children.  I don't have cable because I can't afford it.  I brew my own beer because I can't afford to buy beer.  I have a computer I can't use because I don't have the space in my budget for a used monitor for it.  I'm going to stop driving to my gaming group because gas is too expensive.  I have as of yet to buy a television.

If you told me I could keep all of the things I listed and not have to spend 50 hours a week associated with going to work, I'd say sure!  If all of my costs were covered, I would make more money begging on the street than I would going into the office.  I know this is anecdotal, since there's only one of me, but yes, if you told me all of my basic needs and my children's education would be covered, I would quit my job in a heartbeat.



The current system doesn't pay by quality, I suspect anything new we put up wouldn't either.




#6 (the gov't footing the bill) is the difference between 'health care is a luxury' and 'health care is a right'.  If you think it's a right, you take #6 (as well as probably #7, since the gov't can let people into the plan for free, or reduced costs, as appropriate).  If you think it's a luxury, you don't do those two (or require they still charge).  If you think it's a right which must be protected from abuse, you allow them to do community service instead of paying cash.

Just as aside on the student loans, co-signers aren't always necessary, though parents can take out loans. you can not file bankrupcy on them and defaulting on them is fairly serious. The only way to get rid of such a debt is death. (they don't impose the loans upon your family) I had to take out loans for school and read all the fine print. Taking Master's courses I had to again and the information is correct as of 2005, though it could have changed. And loans are available for any college major. Although extra incentives are offered for specific careers.

*** Would you support a socialised health-care program you could opt out of? I mean, if you're just wanting the government to stay out of your business, I would say that's absolutely your right, and no one should infringe on it. But what about those of us who're okay with a little interference? So we make a program that people who want can opt into, and people who don't want can opt out of. Sound good?


*** Well, that would explain why I'm in favour of it ....


*** You consider the cost of the military to be "almost negligible"?


*** Do you have any basis for this belief?


*** Okay, so what costs do you think there are that aren't outweighed by the benefits? Also, on the subject of #1 there, what about freedom from illness?


*** Okay, so why not bring back indentured servitude? I'm not being at all faceitious (sp?); I really think we ought to.


*** I must've missed something. How do we know it would be "shabby care"?


*** So then your position would be that anything not explicitly disallowed by the Constitution is acceptable?

Most likely, yes, I'd support that, assuming your opting in or out truly had little or no interference on me.  The problem is, if we did that, the people who would opt in are those who can't afford (or don't want to spend money on) health insurance, and those that would opt out would be those who have the money for the nice health insurance, so it wouldn't exactly be much of an improvement.




Hardly, but for instance, the cost of student loans should be, in theory, almost negligible.  The amount of money we pay on say NASA or NOAA is very, very little, per person.  The military is a different discussion.  Having SOME military is necessary, since we need to be able to defend our nation against invaders, but having a military large enough to conquer and hold other nations isn't just unnecessary, but it's dangerous.  Is there a reason our military is bigger than all the other militaries of the world combined?  Because I can't see any.  And you as a taxpayer shouldn't have to pay into that.  But if you try to stop, people with guns break into your house, take your stuff and toss you in jail.  That's just as bad as forcing people into paying for someone else's hospital stay without your having in any say in the matter.



Only the Constitution.



I don't believe we have, or should expect, a freedom from illness.  Should I expect a freedom from hardship?  From chance?  That's ridiculous.

What makes it a bad deal?  If I pay $2,000 for $1,000 in service, that's a bad deal.  If I pay $2,000 for someone else to get $1,000 in service that's a REALLY bad deal.



If protected from abuse, it's an option.  To a degree we already do it in some places.  The government right now will pay your college tuition in exchange for four years of military service.  I wouldn't mind the government offering to pay for your medical treatment in exchange for a few years of civil service.  From what I understand, initially welfare under FDR was that; the fed gives you a job and that's how you make that 'free money'.  I don't know why we dropped it.  To do otherwise encourages abuse.



Firstly from all the reports we've been seeing from people in nations with socialized health care reporting that there are long lines and poor accountability.  Secondly, in any system where performance is not properly incentivized, most people will provide poor service, and most social health care programs around do not appropriately incentivize good performance.



I don't think we should get into that in this thread.  Technically, the Constitution already says the federal government has no power beyond those outlined in the constitution, so they don't have any powers not in the Constitution.  However, the Fed Gov't can offer certain services, like USPS.  But to go into the specifics of why one and not the other is probably a conversation all of its own.

Secondly, in any system where performance is not properly incentivized, most people will provide poor service, and most social health care programs around do not appropriately incentivize good performance.

People who choose to devote their lives to medicine tend to have motivations above desire for money.

I don't believe we have, or should expect, a freedom from illness.

Do we have a right to life?

The number of people who have the time, intelligence and money to invest in becoming a doctor are few, and many of them are already being pulled into quite a number of other areas which are already suffering a serious lack of manpower.



The two are not equivalent.

The number of people who have the time, intelligence and money to invest in becoming a doctor are few, and many of them are already being pulled into quite a number of other areas which are already suffering a serious lack of manpower.

This is just as true in the US as it is in Canada. A person who's smart enough to become a doctor is also smart enough to qualify for any number of other professions, many of which have a greater salary potential than being a doctor.

The two are not equivalent.

Rights that aren't protected can't be said to exist in any meaningful way.

And from what I understand, medical service is better in the US as a consequence.



That's correct, but the US government is built on the idea that the government doesn't have to enforce your rights for and against you, that it only enables you to enforce your own rights.  In the US we believe each person has a right to own a gun, but the government doesn't go out and buy people guns (although I'd really like it if they did...) nor restrict those with money for guns to buy guns for other people.

Really, this line of thought seems quite odd.  I don't see how an organization acknowledging you have basic human rights means that organization is somehow obliged to take the burden off of you for enforcing those rights.

And from what I understand, medical service is better in the US as a consequence.

I'm not quite sure how this relates to my statement. I was merely pointing out that people become doctors for reasons other than money in both of our countries.

Really, this line of thought seems quite odd.  I don't see how an organization acknowledging you have basic human rights means that organization is somehow obliged to take the burden off of you for enforcing those rights.

If I'm a small and weak person, a strong man with a gun could very easily deprive me of my right to freedom, speech and/or life. That's why we need a police force. I view doctors along the same lines. Society needs to provide medical care to people who can't afford it themselves.

What I'm saying is depending on people having THAT MUCH generosity in their hearts is asking for a precious resource to be strained.



This is a great example, actually.

The US Federal government actually has very few police forces, and almost all of them are dedicated to protecting federal assets against people like you (i.e. - not federal assets).  For example, there's the Mint Police, Secret Service (whose primary job has been cracking down on counterfeit money), Alcohol, Tobacco and Firearms, who are charged with making sure people pay taxes on those things and so on.  The only real exception is the FBI, who of course are late-comers to the game, and who still only enforce a handful of laws.  You can't call some number for the FBI to come to your house and protect you (unless by 'protect you' you mean 'surround your house and shoot at you'.  That can be arranged.)  However, no one can argue the federal government doesn't believe in freedom, speech or life.

On the flip side, the state, county and town DO provide police forces, as a service and to enforce the rules of that particular area.  Most states, counties and townships do NOT include a provision saying they will guarantee your freedom, speech or life.  They are simply providing a service.  In times past, some such services were subscription based, although now for ease of use they've generally made it based on geographic region.  If Maryland really wanted to protect more peoples' life and so on, they'd have an agreement with West Virginia, who don't have as many police per capita, and provide protection there as well.  But of course Maryland doesn't, largely because West Virginia is chock full of people who refuse to pay the 'subscription fee' in the form of Maryland state taxes.


So yes, the federal government recognizes your right to life, freedom, good health, etc.  The federal government, however, is under no means constrained to defend such things on your behalf, except in the particular forms it has already been bound to defend (creation of a navy, creating a dependable currency, etc.)

This is true.  But keep in mind that it's also how our current system works.  Some people (ie, healthy people) pay lots of money but get nothing out of it, unhealthy people pay the same amount, and get lots out.  Any kind of health care is going to be a case of some people paying for others.  Also keep in mind that in the current system, the rich are already paying way more for it than the poor are.  It's just that the poor get nothing (and pay nothing) in the current case.


I'm pretty sure it was you who brought up that there's nothing in the constitution about things being fair. ;)  More seriously, though, taxes, by their very nature are unfair.  Even a flat tax is unfair, in the sense that rich people still pay more for the same services (even it's the same percentage of their income as poor people are paying).


I think you need to take into acount that a rich person probably values their health (in dollar terms) than a poor person does.  If you're making $550k/year, you're probably willing to pay much more for your health than someone who's making $55k/year.  $20k for an elective operation?  May seem reasonable if you're making $550k/year, but perhaps not if you're making $55k/year.

I agree that determining how much is 'reasonble' is a non-trivial problem, but I think not imposssible.  Say it costs on average $3k/year for good health care (I'm taking this number out of the air, but I think it's more than the current amount spent per person in the US, which is already higher than anywhere else in the world--even places with socialized medicine).  If the 'average' person is taking in, say, $30k/year (again, just making guesses here, trying to be conservative with them), that's 10% of income devoted to health care.  Would a 10% of income tax be fair, do you think?  Would 5%?

This is in terms of a flat tax, and you're right that it'd more likely be a progressive tax.  Are progressive taxes, in your view, always unfair, or are they ever appropriate?  If it's always unfair, that might be more the issue than the health care itself.





I thought everything not explicitly listed was said to be forbidden.  Whatever the case, though, you're okay with student loans, which is the point.  The benefit outweighs the costs, so it's okay.  If the benefit of socialized health care outweighs the cost, then it seems like that should be on the table too, is my point.


Okay, this highlights my point very well.  This is a situation that no one wants, but you're willing to tolerate.  A good person doing the right thing, but slipping through the cracks.  Unfortunate, but them's the breaks some times.  Alternatively, people in favor of socialized health care say "no, we don't want this person to slip through the cracks.  We should do what we need to help them work their way up."  When conservatives say "but that will let other people get a free ride!" they reply "well, them's the breaks.  We can tolerate that unwanted situation."  Those in favor of the socialized health care don't want anyone who's doing everything right to get left behind because of a bad roll of the dice, and they're willing to let some people who aren't doing everything right to take advantage of the system, if that's the only way to make it work.  Those opposed want to make sure no one abuses the system and gets something they don't deserve, and they're willing to let a few good people doing the right thing to fall by the wayside from time to time if that's what it takes to make sure no one abuses the system.


I think it's a valid point, too.  But what I'm trying to say is that even though that's their motivation, they tend to phrase their arguments as if they're oppose to any and all handouts, fullstop.  They tend to say things like "if you give people handouts, they won't work for it!"  And then they turn around and pay for their child's college tuition, indicating they don't actually believe what they've just argued.


Yeah, that's what I was trying to say.  They don't actually want to stop handouts, even though they speak as if they do whenever these things come up.  I don't think we have to scroll very far up this thread to find examples of this.  They don't actually want to stop handouts, as you say, but they speak as if they do.


Which is a valid point.  Now if we can just get people to phrase it that way!


Yes, I did go to college, did live on campus, and did meet plenty of students.  Granted, it was a small, private school in a rural area, so my experience might not be representative.  But I didn't notice any strong correlation between productivity and paying/being paid for.  Productivity seemed more an issue of what social group/other interests people had.  Even more than that, though, I didn't see much correlation at all between productivity and job-getting.  When I look through the alumni magazine these days, and see who's doing what, I'm over-and-over-again flabergasted at who's become a doctor or lawyer or state representative, or whatever.  I keep thinking "That guy?! you've got to be kidding me!"  My friends who paid for college don't seem to be doing any better or worse, on average, than those who had it paid for by their parents.  Like I said, I'm not sure my experience was representative, but from what I saw, it was more an issue of personality type than who was paying that determined people's productivity, and something else entirely (I'm not sure what) that determined what kind of job they ended up in.


Yes, if I told you you could keep all that without working, surely you'd quit.  But what if I told you you could keep 75% of it?  No beer at all, say, no gaming group, no driving, and no TV.  You can keep your house and your food, but your kids have to go to public school, and you'd give up health insurance?  Now, you'd still be doing better than a lot of people, but I'm guessing it wouldn't be worth it to you.

Similarly, even if you could get all you have right now without working, if someone then said: you can keep all you have, but if you come back to work, I'll give you another $10k/year spending money, I'm guessing you'd take them up on it.

The trick is just making sure that people who are working don't end up worse or the same as people who aren't.  If you're getting free stuff from the government because you're poor, but loose it all if you start working, then you won't have much motivation to work.  If you get to keep it all, and keep what you earn from working, then you'll most likely work.  We can provide a safety net without removing all incentive.  The trick is keeping the safety net in place until you really, really don't need it.



Fair enough, but that's not really much of an argument against any new system.


The community service instead of paying cash isn't a bad idea.  I could support that type of system.

Saw this today, and thought it might interest people here:
http://campaignstops.blogs.nyt...dex.html?ref=opinion

If you're talking about health insurance, that isn't precisely true.  I have health insurance for the same reason my bank buys derivatives; the reduction of risk alone is of value.  However, if I'm paying into a system that gives that assurance to someone else, then all I'm getting is based off of my relationship to that person.



Barring the fact that income taxes are not actually permitted under the original Constitution...

Yes, to a degree taxes are inherently unfair.  They're taking someone's property against his will, and there's few exceptions where that can be completely fair.  However, there are limits to that, where it goes from simply being an unfair inconvenience, to really being unethical.  Where that line is is of course very difficult to decide and set down, but I think in general we all want to shy away from that line as much as possible.



Progressive taxes have their merit.  As you pointed out, a lot of it is based off of disposable income as well.  If I am just barely living within my means, buying only essentials, I cannot spare an additional 10%, whereas if I am living well below my means, buying only essentials, 10% off my paycheck is a nuisance, but not going to kill me.



I'd have to double check, but I believe the government can issue loans at whatever interest rate it pleases.  That's all a student loan is.



I would say it's 'on the table', in that we're discussing it.  However, my paying for some poor guy to get free medical care is not a clear issue of costs outweighing the benefits.  This is why I brought up the idea of medical loans in the first place; since many people complain the problem with socialized health care is the cost, by taking the cost off of involuntary tax-payers and instead putting it back on the person receiving services, it 'eliminates' the cost on the system.



Keep in mind, I also believe there are other sources beyond the government for aid.  There's nothing stopping a person from taking two loans, getting help from his church, getting help from his family, etc.



Because we all know how many elected officials are going to take a paycut for all of the money they're giving away.  The argument is 'no handouts' because they already know THEY will be the ones paying for it, and there's no way out of that.



Now that I have kids, yeah, but before and after kids, I'd probably forego the nice things, or work a little bit to get things like a computer, then be a bum.  So that's about 25 years of work, more or less, to get the kids through school.  Or I'd just move to a nicer area, where the kids can go to a really top-notch public school and only work 8 years.  That would rock.

(My post is a little absent-minded, someone is watching over my shoulder, eager for the one home computer.  *sigh*  May post more later!)

*** Actually, it's not. China has a larger military than the U.S. Ours is just better.


*** Really? I've read the thing, a couple of times, and I'm curious as to where you find that bit of info.


*** Why? I mean, this is (difficult as it is to believe) the 21st Century. And okay, I don't have my jetcar or personal robot servant, but I don't think I'm being unreasonable, in 21st Century America, to expect freedom from illness. No, you're right in that there is always chance, but apart from that, why should any American in this day and time NOT be free from illness.


*** So becos others have done it badly, that automatically means we will?


*** So we have a right to be alive, just a horrible, miserable, sickly kind of life. Right.


*** Unless you're a felon. Becos once someone commits a crime, they're obviously not allowed the same rights as everyone else, regardless of what restitution they may make.


*** Becos it's that organisation's JOB?


*** Unless you're speaking of the U.S. government, in which case they don't give a flip about those things. Just ask any of their guests in Gitmo.


*** Um, isn't that why we pay taxes and such?

That simply put is not true. That happens sometimes, but the list of countries that have successfully dealt with the issue is by no means short. These include Canada, Japan, Sweden, Spain, Ireland and even Cuba.

By the same token every government agency or public service would be utterly corrupt.
This message was last edited by the player at 23:02, Tue 29 Apr 2008.

Well, I hesitate to say this, but I (for one) to believe that.  Having been homeless, lived in a shelter, etc., I can say that most people in that situation did bring it on themselves in one way or another.  Whether it's because they have a famine/feast mentality and aren't fiscally conservative . . . well, that's a major reason right there.  Then there's the mental and/or physical addictions that undermine a persons's ability to care for themselves, most of which a person chooses to take up.

To go onto something of a tangent here, alcoholism can be hideously damaging, but in the vast majority of cases nobody ever holds a person down and forces them to drink, drink, drink until they become an alcoholic.  People become alcoholics because, in my opinion, they choose to engage in a potentially risky activity "for the fun of it".  That's like purposefully driving without a seatbelt just to get a rush -- it's not very smart.  Sure, most people drink responsibly, more or less.  But why drink at all?  To lossen up innate barriers, to "let yourself go"?  How responsible is that?

Ok, to get back to "bringing it on yourself".  In my case, I did bring it on myself.  I choose to move to a busy city with a great economy with no means of supporting myself (at the time I moved) in the hopes of being able to find work, save up, get a place to stay, etc.  It took eight months of living homeless, sometimes in shelters, getting up at 4:00am, walking a few miles to temporary staffing centers (you had to get there early enough that the busses weren't running yet), applying to virtually every business in the area whose qualifications I met and a lot whose qualifications I didn't meet, etc., before I could finally save up enough to get an apartment.  And I was darn lucky (actually, I was blessed) to find some good jobs to transition between.  For instance, I put on commercial copper roofing in the middle of winter.  Sliding around on slick surfaces (icy copper is darn slick), bracing myself against my harness to get some leverage to crimp the copper while hundreds of feet above the ground, but it paid $10/hour.


"It's a good thing the same thing never happens in Canada with their socialized medicine," Bart said, tongue-in-cheek.  Do you know how many people on both sides of the US/Canadian border have similar stories?  Just because your health care provider is the government doesn't mean that nobody ever has problems, that nobody ever falls through the cracks, etc.

Ok, the Canadian government pays and gets you treated quickly if you can prove that your illness is life threatening.  But, that's pretty much the situation that your mother was in.  She hadn't proved, to the insurance company's satisfaction, that her illness was indeed life threatening and I've heard similar stories from people in Canada.

That being said, what company was this with so I can spread the story and help prevent other people signing up with them?  See, that's the major advantage of privatized medicine, you can "reward" insurance companies with positive or negative word of mouth advertising (as appropriate).  With socialized medicine, you're pretty much stuck with whatever you get, it's rather difficult to go to a different company or go to a different hospital for a second opinion and be reimbursed for it later on.

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.
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[[Edit: please ignore spelling/grammar problems in this post, it was written far too quickly.]]

Because that's impossible.  There are three main reasons why illnesses will never be removed from the face of the earth, barring godly intervention or something of the sort:
1) diseases mutate
2) animals cannot be controlled
3) people are stupid

1. The common cold is the prime example.  It's impossible to create an effective vaccination for it because it mutates so readily and there are so many, many different variations it.  Major illnesses that are far less often transmitted, like the flu, still require a different vaccine every year.

2. Many diseases are communicable between animals and humans.  Bird flu, for instance.  Lyme disease is a prime example here.  It's primarily spread by deer tics and deer (who are the main carriers of the disease) aren't really bothered by the disease like humans are.  So unless we could somehow vaccinate all the millions of wild deer and all the other animals that the tics feed on (they primarily feed on deer, but that's not their only possible food source) there's no way to destroy Lyme disease.  Plus, it's kind of like AIDS, we don't have a vaccine for it.  We have a combination of antibiotics which, if taken soon enough, can combine together to knock out enough of the disease in a person that the symptoms of it will generally (in most people) be negligible.  Which leads me to the third point.

3. People are stupid (they make diseases worse, etc.)  A few weeks ago, I mentioned that I wasn't feeling well, that I had a bit of a scratchy throat and might be coming down with something over the next week.  A coworker pulled some antibiotics out of his pocket and offered some to me!  Things like this is what created MRSA http://www.news-medical.net/?id=37026  which, as you can read, is one of the types of common diseases that are resistant to pretty much everything we can throw at it.  Killing it requires such strong measures that we about sometimes kill the human carriers in an attempt to save their life (well, there's no "about" about it, sometimes despite everything we can do the person dies).

I don't mean to belittle you, but it's pretty much a fantasy to ever believe that the world will be disease free.

"But what about smallpox?"  Well . . .
1) Smallpox makes people ugly and so we're willing to throw millions at it to make the ugliness go away.

2) Animals don't really get smallpox, so it's pretty much only communicable through humans, pretty much.  That's huge, right there, it's the major reason that we were able to destroy smallpox.  There's no possible way to stop bird flu.

3. The smallpox virus mutates extremely slowly, so we were able to create a really good vaccine for smallpox . . . and we didn't really create it, in the sense of creating something entirely new, we just copied the cowpox virus and manufactured a vaccine directly from the natural immunization program that nature had already created.  Most diseases mutate more quickly and there's no known natural cure.

That's why we were able to destroy smallpox and even with those advantages, it took years and millions and millions of dollars.

Can diseases in this civilized world be dampened, their effect lessened?  Of course, the world as a whole has great medical resources.  Can we make all disease go away?  Not a chance.
This message was last edited by the player at 02:10, Wed 30 Apr 2008.

     <nods> I stand corrected. What I should have said was "free from serious illness". I'm not concerned with a cure for colds, becos people rarely die from that (tho' I've sometimes wished to ...). But major illnesses, things like Cancer, AIDS, Leukemia ... maybe I mean to say "free from disease"?

Bart, out of curiosity, if you had gotten a serious illness when you were homeless, would you have considered it the best thing for the country to just let you go without care?  Do you think the US would be better off treating you, so that you could continue to do the hard work, put in the hours, and work your way out of that situation?  If you had gotten hit by a bus, say, and couldn't do any work for months, should the government have left you to starve, or would it have been within their best interests to help you while you were laid low?

In regards to number of people they're larger, not in regards to dollars spent.



10th amendment:
"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

In other words, if the Constitution has not explicitly said the Federal Government has a certain power, it does NOT HAVE that power.

Now go back and read the preceding 9 amendments and the Declaration of Independence (as well as the Federalist, if you have the time).  Every one of those documents describes solely the protection of people from the enroaching power of a federal government, of limits on government, and of the powers of government largely against itself and a select number of services offered to people in order to protect their freedom (printing money, a court system, a navy).




As Bart said, it really is unreasonable.  Not only is it unreasonable, but it's unhealthy.  To never be exposed to illness results in a myriad of other negative health effects.

You've since corrected yourself, to never be exposed to serious illness.  Well that comes with a price.  We COULD eliminate AIDS in the US relatively easily; through the mandatory testing of the entire US population (or at least the majority) and consequent sterilization or ejection of infected individuals.  Unfortunately, there is no other technology currently available to end AIDS.  So, is that a course you'd support?  I suspect not.



To not learn from the mistakes of others is foolishness.



We have a right to a life that is a product of our fortunes and choices.  Remember, this isn't a right given by the government, we're discussing the natural rights of every human being, American or not.  Even if there is no government, we would have a right to life.  But part of that natural right is the fact that life is not easy, it is not guaranteed, and it is not naturally completely comfortable.  So yes, we have a right to life, in all its beauty and terror, and the government, not just the US government but ANY government, steps beyond its bounds if it means to forcibly restrict us from that.

If a government offers a service to modify that right to life, and we voluntarily accept, that is okay, but that isn't the same as a right to life.



That's a strong point, but for a different debate.



How is that the government's job?  Because it's a government?  I think you'd have a difficult time proving that, through the history of human life, the government's job has clearly been that of protecting the basic human rights of its constituents.  Because it's the US government?  There's nothing in the Constitution that says the US government must enforce your rights on your behalf.  In fact, quite to the contrary, the founders made it clear the government will one day impinge on those rights, and on that day it is *OUR* responsibility, not the government's, not some other body's responsibility to enforce those rights again.



No, you pay taxes because your elected officials realized they control all the guns, and the best way to keep themselves as your well paid elected official is to take your money and give it to the circus or themselves.  I don't think the 16th amendment ever mentioned anything about how your taxes will be used to actually benefit you (and this is precisely what the government was denied the power to tax beforehand, because the government will use that power not to help you, but to help itself.  The government is not altruistic.  The government does not 'like' you.  The government works for itself, it is a living organization whose constituent parts want to support their ongoing careers and success, even if the cost of said success is levied against an involuntary victim.)



We've had one person report that his experience in Japan was precisely that.  I suffered socialized medicine in Moscow and I can also vouch for it, although I don't think anyone would want to count Russia 1989 among the examples of socialized medicine.  I would be interested in seeing an average wait time between US public and private hospitals, and an average wait time between US hospitals and say Canadian hospitals.

This isn't to say that these people are corrupt, but simply that large groups of people are not going to simply sacrifice themselves.  There's a reason Mother Theresa is considered a saint, and it's because she's unusual in her accepting her life is better spent not pursuing her own best interest.  And if you were offered a choice between a job paying $70k and helping poor people in a stressful environment and $140k and helping rich people in a pleasant environment, I would not fault you for choosing the latter.  If you disagree, then why aren't you currently working in the Peace Corp, or doing charity work for someone with more need than yourself?

I tried to track down some figures on this, and this is what I've found so far:
http://www.businessweek.com/te...c20070621_716260.htm



This one doesn't seem very neutral, but has a number of citations to check:
http://www.cwhn.ca/resources/cwhn/privateClinics.html

This one doesn't seem so neutral, but brings up some interesting points:
http://www.prospect.org/cs/art...ealth_care_is_so_bad
I especially like the point about wait times, and how they don't factor in the people who don't get any treatment at all (ie, "wait" forever).  In other words, a person in the US who does end up getting treatment for a non-emergency might wait less than those in other countries, but many people in the US don't end up getting the treatment at all.  Is it better to have 3 people out of 5 get quick treatment, or all 5 get slightly less quick treatment?

Here's another one that ranks the countries in the commondwealth fund's survey:
http://www.commonwealthfund.or...ow.htm?doc_id=482678
(note--the full document is downloadable in pdf form, the link is just an overview)

And just to get some level of balance, here's a link to Fox news:
http://www.foxnews.com/story/0,2933,136990,00.html


Er...throwing balance back out, here's the huffington post:
http://www.huffingtonpost.com/...aiting-_b_55749.html


One from consumer affairs which talks more about the rate of errors:
http://www.consumeraffairs.com.../medical_errors.html

I've just concluded a second tour of duty on a volunteering work on education reform in Serbia and frankly I've had enough. (And I wouldn't be surprised if after I die my church declares me a saint, but that's their stupidity.) But let's face it, we need to calculate average wait per dollar spent. Without question European health care system gives much better results than in the US.

Tzuppy, thank you for your service, you're a better man than I.  Now if I may ask, how many other people do you see willing to dedicate their lives to the service to others?  1 per 10 people?  1 per 100?  1 per 1,000?  How many social-support jobs are we looking to fill?

Tycho, good research.  I noticed a few interesting things.  Firstly,

Secondly, the dominant factors quoted by Business week weren't problems with paying, but rather:



In other words, we need to make more doctors, more health care providers, and give them fewer restrictions and less paperwork.  That means reducing salaries is the worst thing we can do.  The article goes on to point out that the market, not the government, is responding in the form of "minute clinics".

It would seem that, despite Falkus' regularly crowing how terrific the Canadian health care system is, it seems to fall behind even the US in regards to providing care.  From what I can tell, the cause is that Canada makes it illegal to offer private medical care, period.  This is contrary to most every other industrial nation.  The truth is, public health care does not adapt quickly to changing conditions, it's very static.


One of the articles Tycho posted was that the difference between non-profit private hospitals is significant compared to for-profit private hospitals, presumably because of the reasons Tycho has already cited.  If that's the case, we shouldn't be focusing on eliminating or even marginalizing private care, but rather shifting the drive for profit to one that encourages good care.  Like Tycho pointed out, generally for-profit companies will find that it's worthwhile to treat 90% of their paying patients, but not 100%, and none of the non-paying customers.  So we need to increase the cost for that marginalized 10%, mostly through negative publicity and advertising, since that's most straightforward and, if we want to take care of the non-paying, incentivize that through government programs.  This comes back to the numbered suggestions I made previously.  Trying to manage everything under a single government program has its own flaws, and will limit medical research and adaptability.  Rather, we need to change the game so that treating every customer is seen as valuable and let the market solve the problem itself.

I think the first point got lost somewhere? ;)


I think everyone would agree that we could use more doctors, and give them less paperwork.  The main source of paperwork, though, is the private insurance industry.  I read a while back that on average, every doctor in the US has at least one full time employee who's main job it is to deal with sorting out insurance claims.


Actually, I think the study that all these articles were talking about showed that canada is making some improvements in waiting time (the area in which the US beats it).  But I think we need to remember the fact that people who don't get treated at all aren't being factored into a waiting period in the US.  As I said before, is it better for 3 of 5 people to get treated quickly, or all five to get treated less quickly?  I'm not opposed to private AND public health care, though one of the articles pointed out that this actually tends to increase waiting times in the public system by taking doctors out of that system.  I think the key would be to make sure that any public system is competitive with private systems, so that the private system doesn't end up with all the best doctors.


I don't disagree with this in principle, but when you're "increasing the cost for the marginalized 10%" and "changing the game so that treating every customer is seen as valuable," I think we're already in a situation where we're not actually "letting the market solve the problem itself."  To a degree, anything that achieved that could probably be described as socialized health care.  We're actively toying with the market at that point, in order to get the results we want.  That may well be the way forward, but I think we shouldn't pretend at that point that we're leaving the market on it's own.  The bottom line is that the marginalized group is marginalized because it can't pay the cost of the health care it needs.  The only way to make it profitable for the hospitals to treat them is to have other people pay for it.  There are various ways to achieve that, and it can also be argued that if they can't pay, they shouldn't get treated.  But there's no real way that market forces are going to result in those people being treated without other people paying the bill.