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[Blacken]

Well, I guess I can somewhat agree with you, then. If I see this as just the rough way to get medical science to progress faster, sacrificing a short-term benefit for a long-term larger one.*
The problem that I see with this is that it will give more means, without assuring that those means will be used for the good of everyone in the future, whereas the UHC approach takes a step in this direction. In other words : let's say you continue with the current system. When we've cured cancer, cured AIDS, and when every bit of effort put into saving a billionaire from an obscure sickness can save a thousand lives where people still die from cancer and AIDS, then why wouldn't the richer half of the country use this - now flawed - argument again ? Where is the line drawn, where you have to switch from long-term planning to actually helping people ? More change would have to be brought, and quicker, upon a society used to a very different thinking, and you can't be sure the right decision would be taken at this point. In light of this, maybe socialism takes little steps, but it takes them in the right direction.
However, you can't actually judge something according to this kind of very abstract thinking because you would need to get into an awful lot of technical details to have an idea about what decision would ultimately be better. I'm just saying this hoping you haven't already considered it.

*Knowing whether it is the case in reality, according to numbers and statistics and other stuff, is another problem, but I am not that interested in it, so let's say you have a point too and leave it at that.

I have considered it, and rejected it as being more than a little silly, as it's not something that will ever need serious consideration. It is a "what if" that can't happen.

Put simply: there's no appreciable benefit to UHC in the long run, even if applying capitalistic inducements to innovation to the medical field. Because, quite frankly, not every life is worth saving. We've determined, over a very long period of time, that the people who are most valuable to society--the most skilled and least replaceable--will be compensated with money. The people who can pay, will pay. The people who can't--well, as uncomfortable as it may be to consider, they're generally replaceable.

If you don't want to be in the latter category, make yourself irreplaceable. Nothing's stopping you except yourself.

[Leafsnail]

What would you say about, for instance, disabled people who cannot work?  If they have, say, cystic fibrosis?  Should they just be allowed to die as they'll never be able to work and contribute?  If you say "Yeah, it'll never affect me" would you think the same way if, for instance, one of your children had such a disease?

[Aqizzar]

Well, this turned out exactly like I thought it would.  Once words like "sheeple" and "liberal bias" and "death education" start getting thrown around the party's over anyway.  And of course, Blacken's more concerned with causing a scene and Architect doesn't know who he's responding to from one post to the next.  But maybe I can do some good here - allow me to refer to some factual evidence (remember that stuff?) for the sake of a coherent argument.

A little while ago, that renown arch-liberal Keith Olbermann (please don't spit on your monitor until I'm done) started advocating for the National Association of Free Clinics, an organization that gets doctors to populations where people need health care but can afford it or find it locally.  They used to go to the third world, now they go to American suburbs.  They haven't hosted a venue yet that wasn't packed, mostly by working people, often with nominal health insurance.

They needed the free help anyway because they either couldn't afford even the co-payments on their insurance, because their employer won't let them enough hours to qualify for full coverage, or any one of a thousand lawyering tricks to deny them coverage they thought they had.  So the idea that the only people who want free health-care (which apparently is also a plot to kill people or something?) are lazy people who want everything handed to them is, of course, bullcrap.

Speaking of charity as whole, here's a math problem.  Consider an ordinary American family, two adults and 2.3 children.  Further consider that they make a combined income of $125000 a year.  How good of health care do you suppose they can afford out of pocket?  How much would they have left over afterward to kindly give to the less fortunate, supposing they were even willing to?

If your combined household income is $125000 a year, you're in the top 10% of American income earners.  That seemingly innocuous (to some people) budget is technically rich.  The wealthiest 3% of American taxpayers make (or at least report) about as much income as the entire 97% below them.  This is why the wistful insistence that charity should be enough is also bullcrap.  Only a tiny fraction of people in America can even afford to be charitable on a effective scale, and the very fact that we're arguing about healthcare proves they are not willing to.

So what's the answer then?  I'm not arguing for government mandate charity or something (although you'll certainly insist I am, to America's swift self-immolation or whatever).  There's plenty of different, rational, approaches to healthcare legislation that won't make the sky fall or make a life without imminent fear of illness a privilege of the rich.  For instance, Switzerland and the Netherlands use fairly similar systems, whereby the entire population has full access to affordable healthcare with better statistical outcomes than America and without a dime of public money.  How?  Health insurance is treated as a heavily regulated utility, like electric companies, with mandates on access and price controls.  In other words, taking the profit out of other people's sickness, like America should have done 70 years ago.

In summation, universal healthcare is entirely possible, the people advocating it are neither retarded puppets of the evil state nor self-indulgent whiners, soooOOOooocialism is a not a pact with the Devil even where it's the appropriate term, and voluntary goodwill is not a policy solution.  But hey, it's the holidays, so let's try that anyway.  If you're not afraid of your hands burning from touching something Keith Olbermann did, why not donate some money for people who can't afford to pay for continued living themselves?  I just sent $50.  Will you send a few bucks?  Because if your answer is anything but "yes, immediately", then that's pretty much quad erat demonstrandum on why your entire philosophy is total bullcrap.

Put simply: there's no appreciable benefit to UHC in the long run, even if applying capitalistic inducements to innovation to the medical field. Because, quite frankly, not every life is worth saving. We've determined, over a very long period of time, that the people who are most valuable to society--the most skilled and least replaceable--will be compensated with money. The people who can pay, will pay. The people who can't--well, as uncomfortable as it may be to consider, they're generally replaceable.

If you don't want to be in the latter category, make yourself irreplaceable. Nothing's stopping you except yourself.

You are a heartless monster, and more to the point, exactly one of those "replaceable" useless people.

[Blacken]

I am most certainly not a heartless monster. It's in a jar in my closet, third shelf from the bottom. You also seem to conflate "replaceable" with "useless," but that's okay, that's a common failing among people whose interest lies in . A janitor is useful and replaceable. The marginal cost for hiring and training a new janitor is very low. A doctor is useful and much less replaceable; the marginal cost for training a new doctor is high. This is why we pay doctors more--because it is much harder to replace them and there are not that many of them. If it were free to provide health care to everyone, of course it would be a no-brainer to do so. That said--it's not free, and somebody's got-ta pay. Overloading the progressive taxation system (which is a certainly necessary system, as far as it goes) even further is something that requires a hell of a lot more thought than "we want it and the rich can pay for it," and the time to explore the options fully and make a reasoned decision at the end of the day is not being taken. The American government does not do "fast" well, and when it attempts to respond to quickly changing public sentiment, it cocks up quite a bit.



More seriously: Aqizzar makes entirely cogent points, and if your goal is, independent of all factors, to provide health care to everyone, it's an incredibly compelling argument for what is indeed a rational solution to healthcare. Rationality does not make it good, however, and by "taking the profit out of health care," you reduce the impetus toward 1) providing high-quality care, because there's no rational-actor reason to do more than the minimum, and 2) progress within the medical field, because there's no reward in doing so (unless now you want the state to be the primary driver of that--at which point you are returning to government existing to perpetuate itself, and while larger government is not an inherent bad, I can't think of a historical case where it's ever proven good over the long term). How are you going to solve that, Aqizzar, when you take out the reason to provide health care? Right now innovation is very largely driven by profits from American health care consumers--where's the money going to come from? "Tax the rich" sounds good until you start running out of their money.


Socialism is not inherently evil and to imply that those who are in disagreement with you are saying such is disingenous; I don't think anyone who knows what socialism actually is would call it such. I, personally, would call it an abdication of personal responsibility, but societal immaturity is not evil. Like I said, I'm not terribly invested in the result as far as UHC goes--I'll be fine either way. Compared to other UHC systems, the Swiss have a reasonable one, and I'd be quite alright with reasonable, cautious steps toward implementation of a similar system, provided that there are clauses to reverse the changes if metrics of effectiveness aren't met (if it cannot prove its worth, why continue?) and the innovation problem can be addressed. The biggest problem I have with the propositions currently under consideration in this country is the complete lack of reserve or prudence involved. I realize full well that the politics of the situation require them to push through as much as possible (as the Democrats will be getting their asses handed to them in 2010, packaged pretty and with a pink bow), but that doesn't excuse the irresponsibility of it. When the people voting on the bill haven't read it (this is a problem across both parties and all issues, but particularly egregious when there is no undo button on the legislation), there is a bigger problem than UHC.



It's not monstrous to ask "can we pay for it, and is it worth it?". It's irresponsible not to.

[Leafsnail]

More seriously: Aqizzar makes entirely cogent points, and if your goal is, independent of all factors, to provide health care to everyone, it's an incredibly compelling argument for what is indeed a rational solution to healthcare. Rationality does not make it good, however, and by "taking the profit out of health care," you reduce the impetus toward 1) providing high-quality care, because there's no rational-actor reason to do more than the minimum, and 2) progress within the medical field, because there's no reward in doing so (unless now you want the state to be the primary driver of that--at which point you are returning to government existing to perpetuate itself, and while larger government is not an inherent bad, I can't think of a historical case where it's ever proven good over the long term). How are you going to solve that, Aqizzar, when you take out the reason to provide health care? Right now innovation is very largely driven by profits from American health care consumers--where's the money going to come from? "Tax the rich" sounds good until you start running out of their money.

There are plenty of ways to provide high quality health care without denying it to the poorest people.  Competition can still exist in a system where universal healthcare is provided - indeed, competition can be improved as the insurance companies have to show that they're worth paying extra for.

Britain has had a socialised healthcare system for 60 years, and while it is far from perfect, it still does the job adequately.  It's also, ultimately, more efficient than the American model since it doesn't spend much of its money on advertising and lobbying, and there aren't people at the top to cream off profits.

[Blacken]

There are plenty of ways to provide high quality health care without denying it to the poorest people.  Competition can still exist in a system where universal healthcare is provided - indeed, competition can be improved as the insurance companies have to show that they're worth paying extra for.

No. There are plenty of ways to provide mediocre health care without denying it to the poorest people (and keep in mind that nobody in the United States is turned away for inability to pay; it's already illegal). This is what your NHS does, and, as I understand it, one of the more common complaints among people who don't understand economics, why the quality of health care is mediocre.

There are very few (that can be read as "no" if you like) ways to provide high quality health care without paying for it. As for your silly assertion regarding competition without the profit motive--even Keynes recognized the need for profit to drive competition. If you're hellbent on killing the impetus for improvement, that's okay (well, no, it's abhorrent, but for the purposes of discussion it's okay). Just own it. Stop trying to hide behind saying "well, sure there's still competition!". There's no profit motive, and thus no motive for competition--and thus no motive for efficiency or advancement.

Scarcity exists. There's no magic bullet to remove it. Greater efficiency comes from using scarce resources to work more effectively (by whatever metric). We reward that with profit. The money rules. When you take it away, you have aimlessness. In this country we see it in those much-vaunted public utilities that are supposedly such a good model that we should put health care on it. The infrastructure is generally lacking, capacity hasn't grown a hell of a lot in the last thirty years even though it could be used, and it's technologically backward. Nobody's going to build nuclear reactors when there's no paycheck at the end of the day. Meanwhile, industries that actually profit from their actions--telecoms come to mind--have been steadily rolling out more-and-better. (And to forestall the tired hairshirting--yes, regulation is needed to keep said corporations on the straight-and-narrow. Tearing out their ability to profit is counterproductive.)

Britain has had a socialised healthcare system for 60 years, and while it is far from perfect, it still does the job adequately.  It's also, ultimately, more efficient than the American model since it doesn't spend much of its money on advertising and lobbying, and there aren't people at the top to cream off profits.

The British NHS also isn't funding medical an enormous portion of the R&D costs for the rest of the world. There's a really good reason why British nationals come here if they need something out of the ordinary: 'cause there are decent odds that the British NHS won't have it.

[Little]

* "Liberal", a misused and abused term, for instance: socialism is the farthest thing from liberal. Call it "progressive" if you want, but it's not even that if you know your history. It's actually regressive and restrictive, the opposites of progresive and liberal. Want to go there? Want to throw the word "fear" at anything you don't agree with to make the other person sound ignorant and timid? I'd prefer to skip the obviously cliche political lies of the "liberal" side just as I'd prefer to skip the same tactics when used by the "conservative" side.

As a matter of fact, socialism is a good form of government when done correctly. Labor unions are a socialist party outgrowth, as well as welfare, health care for everyone, and democratic research, Socialism in the 18th century led to the foundation of modern democracy, and the few actual socialist governments that have held true to the ideals have been quite successful. Chile, during the 1960s and the early parts of the 1970s(before the US overthrew the democratically elected government) was successful, and both the ruling parties at that point operated at a socialist platform, the Christian Democrats a more moderate breed of socialists and the Socialist Party a more left-leaning party.

Well, this turned out exactly like I thought it would.  Once words like "sheeple" and "liberal bias" and "death education" start getting thrown around the party's over anyway.

Listen to the man with the chin.

[zchris13]

Do you even listen to yourself Blacken.  I am not asking if you reread your posts, but do you actually LISTEN TO YOURSELF.  You sound like an ignorant politician.  Actually, reading more closely, an ignorant economist.

Actually, only emergency cases are not turned away if you cannot pay.

[Blacken]

* "Liberal", a misused and abused term, for instance: socialism is the farthest thing from liberal. Call it "progressive" if you want, but it's not even that if you know your history. It's actually regressive and restrictive, the opposites of progresive and liberal. Want to go there? Want to throw the word "fear" at anything you don't agree with to make the other person sound ignorant and timid? I'd prefer to skip the obviously cliche political lies of the "liberal" side just as I'd prefer to skip the same tactics when used by the "conservative" side.

As a matter of fact, socialism is a good form of government when done correctly. Labor unions are a socialist party outgrowth, as well as welfare, health care for everyone, and democratic research, Socialism in the 18th century led to the foundation of modern democracy, and the few actual socialist governments that have held true to the ideals have been quite successful. Chile, during the 1960s and the early parts of the 1970s(before the US overthrew the democratically elected government) was successful, and both the ruling parties at that point operated at a socialist platform, the Christian Democrats a more moderate breed of socialists and the Socialist Party a more left-leaning party.

To a certain extent, practices espoused by socialists make sense. They really do. The problem with them is that they encourage short-term thinking in a remarkably similar method as uber-capitalism: "it won't hurt us to do this now, so let's do it!". The scions of power in an idealized capitalism do so to enrich themselves to everyone else's detriment--the people of the Socialist Paradise mortgage the future to benefit themselves now.

Tipping the scale too far in either direction is the problem.

Do you even listen to yourself Blacken.  I am not asking if you reread your posts, but do you actually LISTEN TO YOURSELF.  You sound like an ignorant politician.  Actually, reading more closely, an ignorant economist.

I am sure that, to you, I sound ignorant because you disagree with me. Admitting you have a problem--that's key. And you're making a fine start! I'm so proud.

Do you want a hug?

[Zai]

Do you want a hug?

Do you know what you just did?

You just opened the door to Armok having a hug-fest.

[Cthulhu]

Good lord what you done?

[zchris13]

Truly.  And no, Blacken.  I do not disagree with you.  You just lack the sort of real world backing for your ideas.  No evidence, see?  Just theories.

[Ampersand]

Is this going to become another black hole like the thread that shall not be named?

[Leafsnail]

There's plenty of competition.  If you dislike the NHS, you can still get private insurance (yes, we have that here), and, what's more, the private insurance has to be better in order to compete with the NHS.

Anyway, I'm not suggesting a move to communism, which is what you seem to be implying.  I'm just saying that, at the end of the day, it's better if we treat basic healthcare as a human right.

[Zai]

Is this going to become another black hole like the thread that shall not be named?

I'm not sure which one you mean. That's the problem with unnameable threads; you never know which unnameable thread it is.