Author Topic: Universal Health Care Practicalities  (Read 8701 times)

Poundwise

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Re: Universal Health Care Practicalities
« Reply #100 on: February 03, 2019, 06:04:44 PM »
NYT had an article yesterday about the current political status of universal health care in the US.
https://www.nytimes.com/2019/02/02/us/politics/medicare-for-all-2020.html

GrayGhost

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Re: Universal Health Care Practicalities
« Reply #101 on: February 03, 2019, 10:37:13 PM »
A fat 'product' tax:  Instead of taxing people why don't we change how we tax products. For those of you who don't know, the US has a tax subsidy on corn, wheat, sugar, and meats. However it has very little incentive to farm fruits and vegetables. Let's switch that around! We also already tax tobacco and alcohol quite a bit. Let's extend that to soft drinks, and set it up so the tax revenue from all three has to go to medicare. Americans don't like extra taxes, especially if they consider the results to be waste, but I think a tax on unhealthy habits used to pay for future health expenses is something you could get acceptance for.

There are a few problems with this proposal.

One is the abstract issue of (further) complicating and bloating an already byzantine tax code. Another is that it rather runs against the principle of bodily autonomy, in that only an individual should decide what he/she puts in his/her own body, and a tax or fine or other state-imposed cost on the matter is a violation of bodily autonomy.

A third issue is that selecting which products to tax opens the door up to special interests and lobby groups to create exemptions for their own products and extra taxes on rival products. We can avert this risk is with extremely simple laws, or extremely honest politicians.

On the thought of not trusting people:  The poor in the US already have free healthcare. It's called medicaid. Between that and medicaid the poor and the elderly are covered. It's just the young to middle age middle and upper class who are paying for their own healthcare.

Right, but the US government already spends a fortune on healthcare just for covering these select few. Unless there are price controls in some form (whether through law, competition, or something else) there is going to be a fiscal impact of covering more people.

In addition, the poor also get free food in the form of food stamps. Let's change how food stamps can be used and accomplish a few goals. Instead of X dollars and you can spend it however you want, let's set it up so the recipient gets a free allotment of healthy foods. What I'm getting at is that the recipient gets a lot of fruits, vegetables, rice, beans, lean meats, etc. but no processed chips and sodas. If they want to buy those things they can use their own money. This would in effect make our poor population much healthier, clear up some food deserts since there would be automatic added demand for these goods, and save a lot of money on public healthcare be it universal healthcare or medicaid. It would also create greater demand for these goods, which combined with fixing food subsidies, would give farmers incentive to farm a lot more healthy foods.

A free allotment of healthy foods sounds nice. It also sounds quite a lot like what Cuba does.

Subsidies indeed incentivize certain acts, but there are colossal second and third order effects that many not always be easy to see, and there's no guarantee whatsoever that they will result in intended first order effects at all. Take corn subsidies, for example... sure, they result in relatively cheap corn products, but there are also huge problems with them and they've resulted in the use of HFCS, which has its own issues.

Then there's the issue of who gets to decide what a "healthy" food is, along with the bodily autonomy issue... sure, the government wouldn't be forcing anyone to eat certain things per se, but it would steer you rather decisively towards certain personal lifestyle choices. That's a problem.

pecunia

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Re: Universal Health Care Practicalities
« Reply #102 on: February 04, 2019, 06:38:32 AM »
NYT had an article yesterday about the current political status of universal health care in the US.
https://www.nytimes.com/2019/02/02/us/politics/medicare-for-all-2020.html

From the article:

"But Michael R. Bloomberg, the former New York City mayor who is considering a 2020 bid on a centrist Democratic platform, said it would be folly to even consider a single-payer system. “To replace the entire private system where companies provide health care for their employees would bankrupt us for a very long time,” Mr. Bloomberg told reporters in New Hampshire on Tuesday."

Good use of fear.

The country is being pulled towards more Socialized medicine.  I don't see how we would be bankrupt if all those companies no longer had that significant human resource cost.  Overall the country would pay less.  This is an example of economic efficiency.  It would be good for business (other than insurance).  It would be good for the average Joe as the overall cost would be less.  I think most of the countries that offer medicine to their citizens are doing well.  They are not bankrupt.

I think smart Republicans would pick this up and run with it.   They could be offering Socialized medicine purely on economic justification.  They would just have to call it something else, maybe "people's medicine." They would lose their health care lobbyist support, but they'd cut the legs off of the Democrats and it would benefit them with new voters for a generation.  I am old enough to remember hearing a lot of old timers praise FDR.

shenlong55

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Re: Universal Health Care Practicalities
« Reply #103 on: February 04, 2019, 08:26:50 AM »
Then there's the issue of who gets to decide what a "healthy" food is, along with the bodily autonomy issue... sure, the government wouldn't be forcing anyone to eat certain things per se, but it would steer you rather decisively towards certain personal lifestyle choices. That's a problem.

Considering the personal lifestyle choices that "the market" has decided to steer people towards so far are you certain that it's a better driver than us?  If so, when do you expect it to correct it's current course?

Kris

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Re: Universal Health Care Practicalities
« Reply #104 on: February 04, 2019, 08:37:00 AM »
Then there's the issue of who gets to decide what a "healthy" food is, along with the bodily autonomy issue... sure, the government wouldn't be forcing anyone to eat certain things per se, but it would steer you rather decisively towards certain personal lifestyle choices. That's a problem.

Considering the personal lifestyle choices that "the market" has decided to steer people towards so far are you certain that it's a better driver than us?  If so, when do you expect it to correct it's current course?

+1.

ketchup

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Re: Universal Health Care Practicalities
« Reply #105 on: February 04, 2019, 08:42:05 AM »
Also, corn and whatnot being subsidized and therefore super cheap, is already the government steering you rather decisively towards certain personal lifestyle choices.

SunnyDays

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Re: Universal Health Care Practicalities
« Reply #106 on: February 04, 2019, 10:31:02 AM »
EVERYONE does something that is "self-destructive."  It's only a matter of degree.  Have you ever eaten junk food, drunk alcohol, did something foolish that could have gotten you injured, etc.?  How many times?  Who is going to judge the seriousness of your behaviour and decide whether you deserve to receive medical care as a result?  I live in Canada and we spend a lot less on health care per person than the US does (don't have figures at hand, look it up if you're curious) for generally the same degree of health for the population.  In fact, infant mortality is lower here than there.  I don't think anyone can argue that universal health care is worse overall than a patient-paid system. 

Indexer

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Re: Universal Health Care Practicalities
« Reply #107 on: February 04, 2019, 05:29:30 PM »
A fat 'product' tax:  Instead of taxing people why don't we change how we tax products. For those of you who don't know, the US has a tax subsidy on corn, wheat, sugar, and meats. However it has very little incentive to farm fruits and vegetables. Let's switch that around! We also already tax tobacco and alcohol quite a bit. Let's extend that to soft drinks, and set it up so the tax revenue from all three has to go to medicare. Americans don't like extra taxes, especially if they consider the results to be waste, but I think a tax on unhealthy habits used to pay for future health expenses is something you could get acceptance for.

There are a few problems with this proposal.

One is the abstract issue of (further) complicating and bloating an already byzantine tax code. Another is that it rather runs against the principle of bodily autonomy, in that only an individual should decide what he/she puts in his/her own body, and a tax or fine or other state-imposed cost on the matter is a violation of bodily autonomy.

A third issue is that selecting which products to tax opens the door up to special interests and lobby groups to create exemptions for their own products and extra taxes on rival products. We can avert this risk is with extremely simple laws, or extremely honest politicians.

On the thought of not trusting people:  The poor in the US already have free healthcare. It's called medicaid. Between that and medicaid the poor and the elderly are covered. It's just the young to middle age middle and upper class who are paying for their own healthcare.

Right, but the US government already spends a fortune on healthcare just for covering these select few. Unless there are price controls in some form (whether through law, competition, or something else) there is going to be a fiscal impact of covering more people.

In addition, the poor also get free food in the form of food stamps. Let's change how food stamps can be used and accomplish a few goals. Instead of X dollars and you can spend it however you want, let's set it up so the recipient gets a free allotment of healthy foods. What I'm getting at is that the recipient gets a lot of fruits, vegetables, rice, beans, lean meats, etc. but no processed chips and sodas. If they want to buy those things they can use their own money. This would in effect make our poor population much healthier, clear up some food deserts since there would be automatic added demand for these goods, and save a lot of money on public healthcare be it universal healthcare or medicaid. It would also create greater demand for these goods, which combined with fixing food subsidies, would give farmers incentive to farm a lot more healthy foods.

A free allotment of healthy foods sounds nice. It also sounds quite a lot like what Cuba does.

Subsidies indeed incentivize certain acts, but there are colossal second and third order effects that many not always be easy to see, and there's no guarantee whatsoever that they will result in intended first order effects at all. Take corn subsidies, for example... sure, they result in relatively cheap corn products, but there are also huge problems with them and they've resulted in the use of HFCS, which has its own issues.

Then there's the issue of who gets to decide what a "healthy" food is, along with the bodily autonomy issue... sure, the government wouldn't be forcing anyone to eat certain things per se, but it would steer you rather decisively towards certain personal lifestyle choices. That's a problem.

I'm not suggesting we do anything drastically new. I'm suggesting we revamp what's already in place. There is already an alcohol tax and a tobacco tax, why not an 'excessive added sugar' tax now that we know that is just as bad for health as the former two? I agree a simpler tax system would be nice. Sales taxes do tend to be the simpler of our taxes which is why I thought to go there first. And don't get me wrong. I consume these products, but there is a difference between moderation and drinking liters of soda per day.

Price controls: Prices are a serious problem. My ideas were potential solutions to this that were less restrictive than price controls, which have just as many, if not more, unintended consequences as trying to incentive people eating healthier.

Allotment of food: We are already giving people free food. Currently, this money is used to buy foods that are unhealthy which comes back to bite us later in the form of higher healthcare costs. That's stupid and a waste of taxpayer money. In addition, we currently subsidize foods that are hurting our society and we don't subsidize foods that help our society, another waste of taxpayer money. I don't want to do this because it sounds nice. I like the idea because it takes two existing problems, and improves the situation. It isn't perfect, but it's better than the status quo.

Who gets to decide what 'healthy food' is? Nutritionists would be a good start. It also doesn't have to be just one option. It doesn't even have to be an allotment, that just seemed like a logistically easier option. It could be as simple as food stamp cards not paying for junk food, alcohol(already the case), soda, etc.

GrayGhost

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Re: Universal Health Care Practicalities
« Reply #108 on: February 04, 2019, 06:11:44 PM »
Then there's the issue of who gets to decide what a "healthy" food is, along with the bodily autonomy issue... sure, the government wouldn't be forcing anyone to eat certain things per se, but it would steer you rather decisively towards certain personal lifestyle choices. That's a problem.

Considering the personal lifestyle choices that "the market" has decided to steer people towards so far are you certain that it's a better driver than us?  If so, when do you expect it to correct it's current course?

I prefer the freedom to make your own decisions and live by them, and to potentially be harmed by them, over forced compliance. People are quite welcome to make good choices and I hope they do, but even if they make bad choices, I do respect their rights to do so.

How would you feel if you were "steered" away from doing things that you preferred to, or towards things that you preferred not to?
« Last Edit: February 04, 2019, 06:17:19 PM by GrayGhost »

Mississippi Mudstache

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Re: Universal Health Care Practicalities
« Reply #109 on: February 04, 2019, 07:04:46 PM »
How would you feel if you were "steered" away from doing things that you preferred to, or towards things that you preferred not to?

As has been mentioned above, we're already being steered into choices - like buying products packed with corn syrup due to agricultural subsidies - and hardly anyone notices and even fewer people complain.

Johnez

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Re: Universal Health Care Practicalities
« Reply #110 on: February 04, 2019, 07:18:36 PM »
Well, there are certain things that are undoubtedly unhealthy. Start there. Friend foods, cigarettes, alcohol, refined sugar in products. I mean sure your best friend's uncle ate a Big Mac with Coke every lunch, smoked at work and drinks when he got home and is like 89 years old.......but 90%* of our health problems come from any of these habits in excess. To prevent people who have any number of easily treatable issues from getting decent health care at a decent price simply because others have bad habits is backwards thinking.

*100% not fake stat

GrayGhost

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Re: Universal Health Care Practicalities
« Reply #111 on: February 04, 2019, 07:22:34 PM »
How would you feel if you were "steered" away from doing things that you preferred to, or towards things that you preferred not to?

As has been mentioned above, we're already being steered into choices - like buying products packed with corn syrup due to agricultural subsidies - and hardly anyone notices and even fewer people complain.

I try, when I can.

But this argument confuses me. We seem to agree that it's wrong to steer people, right? So, why is the fact that we are being steered even now an argument in favor of steering others?

To prevent people who have any number of easily treatable issues from getting decent health care at a decent price simply because others have bad habits is backwards thinking.

Who is saying that some people shouldn't get health care, because others have bad habits?

austin944

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Re: Universal Health Care Practicalities
« Reply #112 on: February 04, 2019, 07:52:47 PM »
While I share your concerns about the government, I believe that we have to allow the experiment to proceed simply to move on to other issues.

Statists pushing universal health care will not "move on to other issues" once it is implemented.   When universal health care fails to deliver on its promises, statists will demand even more spending and regulation to "fix it".  Sound familiar?

Getting rid of these failed social programs is very difficult, because the opposition party does not want to be subjected to the ensuing outcry.  They would rather allow it to crash and burn on its own, rather than raise taxes to a stratospheric level in order to make it work financially.  Again, sound familiar?

Dabnasty

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Re: Universal Health Care Practicalities
« Reply #113 on: February 04, 2019, 08:35:16 PM »
While I share your concerns about the government, I believe that we have to allow the experiment to proceed simply to move on to other issues.

Statists pushing universal health care will not "move on to other issues" once it is implemented.   When universal health care fails to deliver on its promises, statists will demand even more spending and regulation to "fix it".  Sound familiar?

Getting rid of these failed social programs is very difficult, because the opposition party does not want to be subjected to the ensuing outcry.  They would rather allow it to crash and burn on its own, rather than raise taxes to a stratospheric level in order to make it work financially.  Again, sound familiar?

Again, do you have any reasoning to back up your claims or anything constructive to add?

Why will it fail to deliver? Do you have data, information to suggest this, a theory. At the very least you could give us a meaningless anecdote. Everyone has an anecdote.

If you take any real interest in this discussion, then give us something we can work with.


Universal health care is an income redistribution scheme.  It takes money away from people who make healthy lifestyle choices, and who live within their means and don't have a horde of children they can't afford, and gives that money over to people who often make unhealthy choices for themselves and the many children they pump out.  It punishes the former and rewards the latter.

No. It's not. Either make a real contribution to this thread or stop trolling.

kei te pai

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Re: Universal Health Care Practicalities
« Reply #114 on: February 04, 2019, 10:39:27 PM »
For heavens sake, just get a group of people with expertise in public health and health economics to pick over policies and practices from the rest of the developped world and be done with it.
Hard to see what could be worse than what you have now.

Leisured

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Re: Universal Health Care Practicalities
« Reply #115 on: February 04, 2019, 11:41:47 PM »
For heavens sake, just get a group of people with expertise in public health and health economics to pick over policies and practices from the rest of the developped world and be done with it.
Hard to see what could be worse than what you have now.

Entirely agree. I live in Australia, and we got universal health care about 1974. In the run up to the 1972 Federal election, a workmate, who came from the Netherlands, said that if Australia gets universal healthcare, we will just be doing what Europe did 15 years earlier. I had to agree.

NZ got universal heath care about the same time, and Canada a decade later.

Learn from other rich countries. The road is open.


Barbaebigode

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Re: Universal Health Care Practicalities
« Reply #116 on: February 05, 2019, 03:54:32 AM »
For heavens sake, just get a group of people with expertise in public health and health economics to pick over policies and practices from the rest of the developped world and be done with it.
Hard to see what could be worse than what you have now.

Trusting specialists is so XX century...

pecunia

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Re: Universal Health Care Practicalities
« Reply #117 on: February 05, 2019, 04:59:30 AM »
For heavens sake, just get a group of people with expertise in public health and health economics to pick over policies and practices from the rest of the developped world and be done with it.
Hard to see what could be worse than what you have now.

Trusting specialists is so XX century...

I find this quite interesting.  People from other countries like England, Australia, New Zealand, etc are just saying, "do it."

USA people are not agreeing to just "do it."  Instead they argue over a somewhat side issue as to whether fat people should be taxed.

I guess I trust the opinions of people who already have such systems successfully in place.

sixup

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Re: Universal Health Care Practicalities
« Reply #118 on: February 05, 2019, 05:18:54 AM »
I love how our ridiculous "defense" (spying, world policing, remote control bombing people, etc.) spending is never questioned, but talk about providing health care to the least expensive subset of the population and suddenly we're gonna go broke overnight.

pecunia

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Re: Universal Health Care Practicalities
« Reply #119 on: February 05, 2019, 05:27:55 AM »
I love how our ridiculous "defense" (spying, world policing, remote control bombing people, etc.) spending is never questioned, but talk about providing health care to the least expensive subset of the population and suddenly we're gonna go broke overnight.

You can spend the money on stuff to kill people or on saving people's lives.

Mississippi Mudstache

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Re: Universal Health Care Practicalities
« Reply #120 on: February 05, 2019, 07:42:23 AM »
How would you feel if you were "steered" away from doing things that you preferred to, or towards things that you preferred not to?

As has been mentioned above, we're already being steered into choices - like buying products packed with corn syrup due to agricultural subsidies - and hardly anyone notices and even fewer people complain.

I try, when I can.

But this argument confuses me. We seem to agree that it's wrong to steer people, right? So, why is the fact that we are being steered even now an argument in favor of steering others?

I'm 100% in favor of the government "steering" its population in ways that are beneficial for both individuals and society. I favor higher taxes on sugar, alcohol, cigarettes, and gas. I prefer automatic enrollment for choices like organ donation and retirement savings. I would like to see more infrastructure spending on public transit and intelligently designed bike paths and less on road widening.

wenchsenior

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Re: Universal Health Care Practicalities
« Reply #121 on: February 05, 2019, 08:02:05 AM »
How would you feel if you were "steered" away from doing things that you preferred to, or towards things that you preferred not to?

As has been mentioned above, we're already being steered into choices - like buying products packed with corn syrup due to agricultural subsidies - and hardly anyone notices and even fewer people complain.

I try, when I can.

But this argument confuses me. We seem to agree that it's wrong to steer people, right? So, why is the fact that we are being steered even now an argument in favor of steering others?

I'm 100% in favor of the government "steering" its population in ways that are beneficial for both individuals and society. I favor higher taxes on sugar, alcohol, cigarettes, and gas. I prefer automatic enrollment for choices like organ donation and retirement savings. I would like to see more infrastructure spending on public transit and intelligently designed bike paths and less on road widening.

It's the 'Libertarian Paternalism' concept, and I am (mostly, with some big exceptions) in favor of it as well.  Structure society so that the healthiest/smartest choices are easiest or cheapest to make, but consider keeping the other alternatives available so that people still have a choice. 

shenlong55

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Re: Universal Health Care Practicalities
« Reply #122 on: February 05, 2019, 10:04:47 AM »
Then there's the issue of who gets to decide what a "healthy" food is, along with the bodily autonomy issue... sure, the government wouldn't be forcing anyone to eat certain things per se, but it would steer you rather decisively towards certain personal lifestyle choices. That's a problem.

Considering the personal lifestyle choices that "the market" has decided to steer people towards so far are you certain that it's a better driver than us?  If so, when do you expect it to correct it's current course?

I prefer the freedom to make your own decisions and live by them, and to potentially be harmed by them, over forced compliance. People are quite welcome to make good choices and I hope they do, but even if they make bad choices, I do respect their rights to do so.

How would you feel if you were "steered" away from doing things that you preferred to, or towards things that you preferred not to?

I'm confused by your question.  Are you trying to say that price differences do not influence your decisions unless those price differences are the result of taxes?

gentmach

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Re: Universal Health Care Practicalities
« Reply #123 on: February 05, 2019, 02:45:06 PM »
While I share your concerns about the government, I believe that we have to allow the experiment to proceed simply to move on to other issues.

Statists pushing universal health care will not "move on to other issues" once it is implemented.   When universal health care fails to deliver on its promises, statists will demand even more spending and regulation to "fix it".  Sound familiar?

Getting rid of these failed social programs is very difficult, because the opposition party does not want to be subjected to the ensuing outcry.  They would rather allow it to crash and burn on its own, rather than raise taxes to a stratospheric level in order to make it work financially.  Again, sound familiar?

Actually, I was more afraid of "Brave New World" growing up than "1984".

Thankfully, I am sure that people will use their new found capabilities responsibly. (https://en.m.wiktionary.org/wiki/liberal_eugenics) I have also been assured by the finest scientific minds on this forum that Gene edited humans are decades away. (https://www.theguardian.com/science/2018/nov/26/worlds-first-gene-edited-babies-created-in-china-claims-scientist
)  Nor will we ever have the capabilities to sustain an fetus outside of a womb. (https://nationalpost.com/health/artificial-wombs
)

Even if these miracle technologies existed, we have always been ruled by just and far seeing men. (https://en.m.wikipedia.org/wiki/Tuskegee_syphilis_experiment

https://en.m.wikipedia.org/wiki/Population_planning_in_Singapore

https://www.nature.com/articles/37848)

I have been assured that nothing can go wrong, to stop worrying and learn to love the bomb.

rocketpj

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Re: Universal Health Care Practicalities
« Reply #124 on: February 05, 2019, 07:00:00 PM »
Universal Health Care delivers just fine here in Canada, as literally any Canadian will tell you - excepting a few highly vocal companies and lobbyists who see dollar signs in a private system.

We had a wave of 'privatization' talk about 15 or 20 years ago, complete with constant talk about taxes being too high and our system being a disaster.  Then we got a federal Conservative government- the supposed avatars of small government and private health care - and they quite smartly ran away screaming from the political suicide that ending the Canada Health Act would have involved.

Bottom line, it's a system that works well for acute care, and medical care.  It isn't designed for prevention, and doesn't have the money to fund prevention efforts.

gentmach

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Re: Universal Health Care Practicalities
« Reply #125 on: February 06, 2019, 04:16:09 AM »
For heavens sake, just get a group of people with expertise in public health and health economics to pick over policies and practices from the rest of the developped world and be done with it.
Hard to see what could be worse than what you have now.

Trusting specialists is so XX century...

I find this quite interesting.  People from other countries like England, Australia, New Zealand, etc are just saying, "do it."

USA people are not agreeing to just "do it."  Instead they argue over a somewhat side issue as to whether fat people should be taxed.

I guess I trust the opinions of people who already have such systems successfully in place.

Actually this was one of my primary concerns with a national system. We would get a system that works great for 7 out of 10 people and then get hung up on minor tweaks and changes that would improve the system overall.

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

Americans seem to think throwing money at the issue will make it go away and that is the limit of their participation.

pecunia

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Re: Universal Health Care Practicalities
« Reply #126 on: February 06, 2019, 05:12:23 AM »

- SNIP -

Actually this was one of my primary concerns with a national system. We would get a system that works great for 7 out of 10 people and then get hung up on minor tweaks and changes that would improve the system overall.

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

Americans seem to think throwing money at the issue will make it go away and that is the limit of their participation.

I think you are right.  There seems to be a large lack of empathy for the people who do not have any form of health care.  The Spring before last our Congress was going to remove millions more from access to health care.  It was called the American Health Care Act.  It was only the actions of John McCain and a few others that stopped this.  They just didn't care about these people.  It was an eye opener to me.

It was different when I was a little kid.  Those old folks from the depression were still around and they had tales to tell.  They had a common experience which they had all been through and did not want it repeated for anyone.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #127 on: February 06, 2019, 06:35:22 AM »

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

How wrecked is "wrecked"?  Canada, Australia and New Zealand were in WWII from the beginning, wit all the expected effects 6 years of war cause, but were not occupied territories with the degree of "wrecked" that implies.

There are certainly cultural differences.  And of course the longer the US waits to shift, the harder the shift becomes, because the present systems become more and more entrenched.

gentmach

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Re: Universal Health Care Practicalities
« Reply #128 on: February 06, 2019, 08:45:30 AM »

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

How wrecked is "wrecked"?  Canada, Australia and New Zealand were in WWII from the beginning, wit all the expected effects 6 years of war cause, but were not occupied territories with the degree of "wrecked" that implies.

There are certainly cultural differences.  And of course the longer the US waits to shift, the harder the shift becomes, because the present systems become more and more entrenched.

I was thinking the London Blitz, France, Europe in general. As Canada and Australia were part of the empire, they were probably horrified by the toll on their countrymen.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #129 on: February 06, 2019, 12:23:25 PM »

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

How wrecked is "wrecked"?  Canada, Australia and New Zealand were in WWII from the beginning, wit all the expected effects 6 years of war cause, but were not occupied territories with the degree of "wrecked" that implies.

There are certainly cultural differences.  And of course the longer the US waits to shift, the harder the shift becomes, because the present systems become more and more entrenched.

I was thinking the London Blitz, France, Europe in general. As Canada and Australia were part of the empire, they were probably horrified by the toll on their countrymen.

Um, there are so many oddities in that last paragraph.  I am sure we were  horrified by what we saw in Europe and the Asian front, but they were not "our" countrymen.  Of course we all had massive casualties, and massive war effort at home, but I am not thinking that is what you meant?

American GIs saw just as much war damage as we did, they were stationed in the UK and were part of D-Day and both the European and Asian fronts.

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Re: Universal Health Care Practicalities
« Reply #130 on: February 06, 2019, 01:01:25 PM »

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

How wrecked is "wrecked"?  Canada, Australia and New Zealand were in WWII from the beginning, wit all the expected effects 6 years of war cause, but were not occupied territories with the degree of "wrecked" that implies.

There are certainly cultural differences.  And of course the longer the US waits to shift, the harder the shift becomes, because the present systems become more and more entrenched.

I was thinking the London Blitz, France, Europe in general. As Canada and Australia were part of the empire, they were probably horrified by the toll on their countrymen.
Tommy Douglas - The father of Canadian Medicare

Wikipedia
Tommy Clement Douglas was born in 1904 in Camelon, Falkirk, Scotland, the son of Annie (nιe Clement) and Thomas Douglas, an iron moulder who fought in the Boer War.[1] In 1910, his family immigrated to Canada, where they settled in Winnipeg.[2] Shortly before he left Scotland, Douglas fell and injured his right knee. Osteomyelitis set in and he underwent a number of operations in Scotland in an attempt to cure the condition. Later in Winnipeg, however, the osteomyelitis flared up again, and Douglas was sent to hospital. Doctors there told his parents his leg would have to be amputated. Fortunately, a well-known orthopedic surgeon took an interest in his case and agreed to treat the boy for free if his parents would allow medical students to observe. After several operations, Douglas's leg was saved. This experience convinced him that health care should be free to all.

All it takes is personal experience with being poor and needing treatment. That was 1910, how would he fare in the current US system?

Jouer

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Re: Universal Health Care Practicalities
« Reply #131 on: February 06, 2019, 02:35:48 PM »

Exactly. People get all up in arms about how "They'll have to raise taxes!!!1! OMG F-NO!!!" Well, last year my health insurance premiums cost $14,000 (that's how much it costs to insure my family of 6 with zero actual spending) and I spent $10,000 in out-of-pocket costs (because we have a special needs child who requires expensive care). That's more than a quarter of my annual income right there. The federal government could literally triple my effective tax rate and I'd still pay half as much for health care as I do right now. Oh, and don't even get me started on the numbers of hours my wife and I spend sorting, paying, and fighting for corrections to our medical bills. If the government actually tallied lost productivity due to our byzantine healthcare system, publicly-funded healthcare would look like a steal.

We still have to do the paperwork for some of the costs incurred out of system* that are covered by private insurance, but it is nothing like this. 

*My pharmacy has my insurance information and I only do co-pay on prescriptions, I don't have to submit the bill to my insurance, they do.  I have to handle my physiotherapy bills.

I don't have any paperwork for the medical part. Some of the welfare system runs on forms, but not the medical one. We have an annual maximal co-pay of about $200, and when we hit the limit, they automatically stop charging us at the doctors', physical therapists' and pharmacies. Even the transport refunds have been automated now. If I have to take the kids to a hospital in a different city, the state will cover the travel costs. It used to be a form to fill out, and you had to send in the receipts. Now we can choose to let them calculate everything automatically, and you only click one box that says "please send the money to my bank account #XXXX". There is no co-pay for the kids, so doctors visits are very easy with them.

I am seething with jealousy right now. I know you pay higher taxes than we do, but dammit, that's what taxes are for.

Do we? If you include the cost of the stuff that is covered by the taxes? Our total taxes ([all tax paid]/[all income]) have the last years been between 20 and 25 %. That is not the theoretical tax bracket, but the amount of our money we paid to the government. It includes state tax, municipal tax, property tax, social security (state pension + medical + "disability insurance"), etc. The only thing that comes in addition is taxes on stuff we buy, like 12 % on food, 25 % on stuff, 100% on petrol and alcohol, etc. Those are difficult to calculate, But based on last years consumption, a rough calculation is that we paid an additional 6 % in taxes that way. People who spend more than us will of course pay more purchase tax.

Someone in Canada (Ontario) making $100k a year and maxing all tax advantaged investment opps (like any MMMer would), pays about $16k in fed and provincial income tax. Someone above from USA mentioned paying $14k for just medical insurance. !!!!!!!!

Adopting a Canadian healthcare method will not cost Americans more than the current system so long as you get rid of the middleman insurance companies who jack up the prices on everything. OF course, that's the problem, isn't it. Those insurance companies pay a lot of money to politicians so no one will ever run on getting rid of them. Another excuse is the lost jobs but there will be job needs to admin the new model so that won't be as bad as people think.

gentmach

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Re: Universal Health Care Practicalities
« Reply #132 on: February 06, 2019, 04:50:30 PM »

I also figure that Americans don't have the underlying culture for the system. We didn't get wrecked during the World Wars. Every other country did, which I believe fostered the idea that "you are your brothers keeper."

How wrecked is "wrecked"?  Canada, Australia and New Zealand were in WWII from the beginning, wit all the expected effects 6 years of war cause, but were not occupied territories with the degree of "wrecked" that implies.

There are certainly cultural differences.  And of course the longer the US waits to shift, the harder the shift becomes, because the present systems become more and more entrenched.

I was thinking the London Blitz, France, Europe in general. As Canada and Australia were part of the empire, they were probably horrified by the toll on their countrymen.
Tommy Douglas - The father of Canadian Medicare

Wikipedia
Tommy Clement Douglas was born in 1904 in Camelon, Falkirk, Scotland, the son of Annie (nιe Clement) and Thomas Douglas, an iron moulder who fought in the Boer War.[1] In 1910, his family immigrated to Canada, where they settled in Winnipeg.[2] Shortly before he left Scotland, Douglas fell and injured his right knee. Osteomyelitis set in and he underwent a number of operations in Scotland in an attempt to cure the condition. Later in Winnipeg, however, the osteomyelitis flared up again, and Douglas was sent to hospital. Doctors there told his parents his leg would have to be amputated. Fortunately, a well-known orthopedic surgeon took an interest in his case and agreed to treat the boy for free if his parents would allow medical students to observe. After several operations, Douglas's leg was saved. This experience convinced him that health care should be free to all.

All it takes is personal experience with being poor and needing treatment. That was 1910, how would he fare in the current US system?

This is what I get for listening to Michael Moore. ("Sicko")

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Re: Universal Health Care Practicalities
« Reply #133 on: February 07, 2019, 05:54:30 AM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

jim555

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Re: Universal Health Care Practicalities
« Reply #134 on: February 07, 2019, 07:28:40 AM »
All it takes is personal experience with being poor and needing treatment. That was 1910, how would he fare in the current US system?
If he lived in an Medicaid expansion state he would do alright in the US.

gentmach

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Re: Universal Health Care Practicalities
« Reply #135 on: February 07, 2019, 11:07:02 AM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

The way I figured it, we came to the agreement to help heal the sick. We would all put money into a pool. That pool, while incomprehensibly huge, is still finite. The system would also have to make a "profit" in order to compensate for other factors. (Rising energy costs, national emergency, etc.)

Therefore it would be necessary for each of us to take what we need and not any more. I would have a moral responsibility to you to be healthy. You would have a moral responsibility to me to be healthy. We would have a moral responsibility to a third person to be healthy.

If a person persists in making bad decisions, they become drag on the system. Which causes problems.

Essentially everyone will have to lower their risk profile in order to make the system work.

Kris

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Re: Universal Health Care Practicalities
« Reply #136 on: February 07, 2019, 11:22:13 AM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

The way I figured it, we came to the agreement to help heal the sick. We would all put money into a pool. That pool, while incomprehensibly huge, is still finite. The system would also have to make a "profit" in order to compensate for other factors. (Rising energy costs, national emergency, etc.)

Therefore it would be necessary for each of us to take what we need and not any more. I would have a moral responsibility to you to be healthy. You would have a moral responsibility to me to be healthy. We would have a moral responsibility to a third person to be healthy.

If a person persists in making bad decisions, they become drag on the system. Which causes problems.

Essentially everyone will have to lower their risk profile in order to make the system work.

I can see that perspective.

And I'd like to add to it.

We would have a moral responsibility to one another, as a society, to make sure that everyone had the potential to be healthy.

Meaning, we'd have a moral responsibility as a society to address problems such as food deserts, and things like the water in Flint, MI. Making sure people had reasonable access to healthy food. And reasonable access to ways to be physically active. And reasonable access to doctors. Things like that.
« Last Edit: February 07, 2019, 11:27:23 AM by Kris »

Jouer

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Re: Universal Health Care Practicalities
« Reply #137 on: February 07, 2019, 11:24:35 AM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

The way I figured it, we came to the agreement to help heal the sick. We would all put money into a pool. That pool, while incomprehensibly huge, is still finite. The system would also have to make a "profit" in order to compensate for other factors. (Rising energy costs, national emergency, etc.)

Therefore it would be necessary for each of us to take what we need and not any more. I would have a moral responsibility to you to be healthy. You would have a moral responsibility to me to be healthy. We would have a moral responsibility to a third person to be healthy.

If a person persists in making bad decisions, they become drag on the system. Which causes problems.

Essentially everyone will have to lower their risk profile in order to make the system work.

Incorrect. See: many posts from Canadians (myself included) and folks from other countries. It works without worrying about any of that.

Chris22

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Re: Universal Health Care Practicalities
« Reply #138 on: February 07, 2019, 11:49:44 AM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

The way I figured it, we came to the agreement to help heal the sick. We would all put money into a pool. That pool, while incomprehensibly huge, is still finite. The system would also have to make a "profit" in order to compensate for other factors. (Rising energy costs, national emergency, etc.)

Therefore it would be necessary for each of us to take what we need and not any more. I would have a moral responsibility to you to be healthy. You would have a moral responsibility to me to be healthy. We would have a moral responsibility to a third person to be healthy.

If a person persists in making bad decisions, they become drag on the system. Which causes problems.

Essentially everyone will have to lower their risk profile in order to make the system work.

Ironically, it's this exact line of thought that results in a lot of right-wing types not wanting government healthcare.  It puts us on the road towards the government suddenly "having an interest" in many other aspects of our life, and we don't want that intrusion. 

Yeah, it's easy to say "well maybe the government SHOULD regulate soda and fast food and candy" but how about another angle; what if the government decides broken legs from skiing is costing the health system too much money, so now there is going to be a skiing tax equal to, I dunno, 50% of your lift ticket if you go skiing, what would that do to most mountain resorts? 

Single Payer healthcare systems is opens up Those Who Know Better Than Us all kinds of potential power to create new rules and laws all under the guise of "we pay for your healthcare so we have an interest in making sure you act in XXX way". 

Yes in theory insurance companies can do the same thing, but as long as there is some choice (I can change jobs, I can push my employer to change insurance companies, I can elect to go on my spouse's benefits instead of mine) there is more potential freedom of choice than if the only answer is the government. 

No thanks. 

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #139 on: February 07, 2019, 11:58:00 AM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

The way I figured it, we came to the agreement to help heal the sick. We would all put money into a pool. That pool, while incomprehensibly huge, is still finite. The system would also have to make a "profit" in order to compensate for other factors. (Rising energy costs, national emergency, etc.)

Therefore it would be necessary for each of us to take what we need and not any more. I would have a moral responsibility to you to be healthy. You would have a moral responsibility to me to be healthy. We would have a moral responsibility to a third person to be healthy.

If a person persists in making bad decisions, they become drag on the system. Which causes problems.

Essentially everyone will have to lower their risk profile in order to make the system work.

Ironically, it's this exact line of thought that results in a lot of right-wing types not wanting government healthcare.  It puts us on the road towards the government suddenly "having an interest" in many other aspects of our life, and we don't want that intrusion. 

Yeah, it's easy to say "well maybe the government SHOULD regulate soda and fast food and candy" but how about another angle; what if the government decides broken legs from skiing is costing the health system too much money, so now there is going to be a skiing tax equal to, I dunno, 50% of your lift ticket if you go skiing, what would that do to most mountain resorts? 

Single Payer healthcare systems is opens up Those Who Know Better Than Us all kinds of potential power to create new rules and laws all under the guise of "we pay for your healthcare so we have an interest in making sure you act in XXX way". 

Yes in theory insurance companies can do the same thing, but as long as there is some choice (I can change jobs, I can push my employer to change insurance companies, I can elect to go on my spouse's benefits instead of mine) there is more potential freedom of choice than if the only answer is the government. 

No thanks.

Wouldn't that actually make our decisions more free though? If you could include the implied healthcare risk of every activity as a tax, then you would no longer be worrying about what decisions people make.

A sugar tax equal in measure to how much sugar consumption increases medical costs. Don't eat sugar, don't pay the tax.

A ski tax that pays for all ski accidents? Don't ski.

This would basically be a fee-based model that conservative politicians love to implement. That way people who don't ski don't feel like they have to pay for the extreme risks of those who do.

Chris22

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Re: Universal Health Care Practicalities
« Reply #140 on: February 07, 2019, 12:04:11 PM »
I was looking for solutions for the "personal responsibility" issue. I would like any system that is created to have "safety relief valves" so self destructive people don't bring the whole system to a halt.

Ever heard of Banking crisis? Climate change? People driving drunken or too fast? People going skiing that have never done it before (Highest risk for broken leg or hip surgery in under 30s)? People getting into debt for luxuries? People getting booed for "not getting a job"?People...

You get it?

Self-caused medical problems are normally at the end of a row of self-caused or others-caused problems.

An generally the small amount of self destructive people is cheaper than the amount of money and work put into trying to prevent them (on what moral basis btw?) from services. Some is true for social transfers.
Just today I witnessed 4 people (or more) with at least 2 meetings involved in deciding about a payout of effectivly less than 240€ (travel costs for getting a job/work test).

The way I figured it, we came to the agreement to help heal the sick. We would all put money into a pool. That pool, while incomprehensibly huge, is still finite. The system would also have to make a "profit" in order to compensate for other factors. (Rising energy costs, national emergency, etc.)

Therefore it would be necessary for each of us to take what we need and not any more. I would have a moral responsibility to you to be healthy. You would have a moral responsibility to me to be healthy. We would have a moral responsibility to a third person to be healthy.

If a person persists in making bad decisions, they become drag on the system. Which causes problems.

Essentially everyone will have to lower their risk profile in order to make the system work.

Ironically, it's this exact line of thought that results in a lot of right-wing types not wanting government healthcare.  It puts us on the road towards the government suddenly "having an interest" in many other aspects of our life, and we don't want that intrusion. 

Yeah, it's easy to say "well maybe the government SHOULD regulate soda and fast food and candy" but how about another angle; what if the government decides broken legs from skiing is costing the health system too much money, so now there is going to be a skiing tax equal to, I dunno, 50% of your lift ticket if you go skiing, what would that do to most mountain resorts? 

Single Payer healthcare systems is opens up Those Who Know Better Than Us all kinds of potential power to create new rules and laws all under the guise of "we pay for your healthcare so we have an interest in making sure you act in XXX way". 

Yes in theory insurance companies can do the same thing, but as long as there is some choice (I can change jobs, I can push my employer to change insurance companies, I can elect to go on my spouse's benefits instead of mine) there is more potential freedom of choice than if the only answer is the government. 

No thanks.

Wouldn't that actually make our decisions more free though? If you could include the implied healthcare risk of every activity as a tax, then you would no longer be worrying about what decisions people make.

A sugar tax equal in measure to how much sugar consumption increases medical costs. Don't eat sugar, don't pay the tax.

A ski tax that pays for all ski accidents? Don't ski.

This would basically be a fee-based model that conservative politicians love to implement. That way people who don't ski don't feel like they have to pay for the extreme risks of those who do.

Orrrr you essentially legislate those industries out of existence.  And then no one skiis.  Supply/Demand tells us that if the price of something increases, demand goes down.  Jack up the price of lift tickets, it's not unthinkable that all of the sudden you've killed enough demand to make skiing unprofitable (at least in the US, rich people could go to Canada or Europe or wherever).

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #141 on: February 07, 2019, 12:05:52 PM »
We do social risk mitigation - but Canadians seem to be more easygoing than Americans about agreeing to social rules that are of benefit.  Things like seat-belts.  Helmets.  Speed limits.  For example, we don't see seat-belts as an infringement on our freedom, we see them as a sensible way to stay safer in an accident.  Those cars where the seat belt does up automatically?  Those were invented for Americans - at the time, Canadian compliance was high, we didn't need them.

Quebec passed a law that a car has to have winter tires on starting mid-December, and apart from a bit of complaining everyone followed it - most were doing it anyway, but in November.  Followup showed a decrease in winter accidents, because the people who thought  all-seasons were OK then had to have the right tires.  We see it as common sense - you have a car, you have it registered, you have a driver's license, you have the appropriate tires on the car.

We also don't do the moral judgement thing about health care - if you are sick, you get it (assuming you are eligible).   They will do risk assessment - if there is a lung available for transplant and 3 people meet the immune system criteria, the person who smokes is least likely to get it.  Simply because things are likely to go better for the person who does not smoke.

Skiiers/snowboarders and broken bones?  Accidents happen.  Is the hill design safe?  No?  Modify it?  Are there accidents on the chair lift?  Check it.  In a resort area make sure there is a hospital with good trauma services. Seriously, Canada has the Laurentians and the Rockies, both big ski areas, and no-one is penalizing skiers who might break something.  Americans come up with more "for your own good" interference ideas than I can imagine, and they are supposed to be the "land of the free".  Is it the Puritan influence still rearing its head?

Chris22

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Re: Universal Health Care Practicalities
« Reply #142 on: February 07, 2019, 12:10:04 PM »
Those cars where the seat belt does up automatically?  Those were invented for Americans - at the time, Canadian compliance was high, we didn't need them.

Sorta.  Those seatbelts were created because the US had a law that after a certain date, all cars had to have a "passive restraint system" which contained unbelted passengers.  This was generally understood to mean airbags, but those seatbelts counted as a passive system in cases where for whatever reason, airbags didn't make sense.  For instance, the design of the car didn't allow for an airbag, the choice was to either discontinue sales until time when the car could be redesigned to allow airbags, or those seatbelts could be put in place as a stop-gap measure. 

Quote
Americans come up with more "for your own good" interference ideas than I can imagine, and they are supposed to be the "land of the free".  Is it the Puritan influence still rearing its head?

Yes, and I for one do not want more, which is what I think Single-Payer health care will invite.
« Last Edit: February 07, 2019, 12:12:02 PM by Chris22 »

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #143 on: February 07, 2019, 12:39:30 PM »

Orrrr you essentially legislate those industries out of existence.  And then no one skiis.  Supply/Demand tells us that if the price of something increases, demand goes down.  Jack up the price of lift tickets, it's not unthinkable that all of the sudden you've killed enough demand to make skiing unprofitable (at least in the US, rich people could go to Canada or Europe or wherever).

Hmm. Nope. Sounds like you're just talking without actually thinking. When was the last time an industry got taxed out of existence?

Let's do an estimate on this.

Let's assume a .5% injury rate per year. So out of 200 people that go skiing in a year 1 gets injured.
Each person goes an average of 3 times per year. So something like 1 injury per 600 rides.
The tax is applied to ski lift tickets. Let's make that a nice round $100.
The average cost of an injury is $10k.

600 * 100 / 10000 = 16%

I gave what I think is an upper bound to this idea. No a $7-15 surcharge for lift tickets to cover additional health risks would not "destroy" the ski industry.

Most states charge a 12-18% rental car tax and that industry seems to do just fine. If the ski industry were truly producing that many injuries and creating a large externality on the general populous, then it probably does deserve to go away. But it's not. So your fear seems unfounded to me.

RetiredAt63

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Re: Universal Health Care Practicalities
« Reply #144 on: February 07, 2019, 12:40:37 PM »
Quote
Americans come up with more "for your own good" interference ideas than I can imagine, and they are supposed to be the "land of the free".  Is it the Puritan influence still rearing its head?

Yes, and I for one do not want more, which is what I think Single-Payer health care will invite.

European countries with universal health care don't do this, the UK doesn't do this, Canada, Australia and New Zealand don't do this.  Is the US so different that it will?  So far you are the only American on here saying this, so I wonder if others think this too.

Also, your Medicaid and Medicare don't do this, why would it happen if there were universal health care for all?  You as a country would be saving a huge amount of money with it, based on per capita costs. (shown below)

Total health expenditure per capita in PPP international U.S. dollars (not inflation-adjusted).[1][3][4] https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita


Country    2013    2014    2015    2016
Australia    4,186    4,289    4,493    4,708
Austria    4,861    5,001    5,100    5,227
Belgium    4,505    4,656    4,778    4,840
Canada    4,461    4,502    4,613    4,753
Chile    1,646    1,737    1,877    1,977
Czech Republic    2,380    2,476    2,466    2,544
Denmark    4,772    4,906    5,058    5,205
Estonia    1,652    1,773    1,885    1,989
Finland    3,920    3,935    3,993    4,033
France    4,331    4,464    4,530    4,600
Germany    4,961    5,200    5,353    5,551
Greece    2,175    2,099    2,210    2,223
Hungary    1,776    1,821    1,913    2,101
Iceland    3,707    3,891    4,106    4,376
Ireland    5,033    5,082    5,276    5,528
Israel    2,423    2,595    2,713    2,822
Italy    3,235    3,271    3,352    3,391
Japan    4,207    4,269    4,436    4,519
Korea    2,252    2,396    2,535    2,729
Latvia    1,224    1,311    1,434    1,466
Luxembourg    6,693    6,850    6,818    7,463
Mexico    1,038    1,026    1,054    1,080
Netherlands    5,303    5,322    5,297    5,385
New Zealand    3,402    3,496    3,545    3,590
Norway    5,979    6,136    6,190    6,647
Poland    1,576    1,606    1,704    1,798
Portugal    2,536    2,599    2,664    2,734
Slovak Republic    2,100    2,009    2,059    2,150
Slovenia    2,586    2,647    2,731    2,835
Spain    2,941    3,057    3,180    3,248
Sweden    5,070    5,170    5,266    5,488
Switzerland    6,794    7,096    7,536    7,919
Turkey    978    1,003    997    1,088
United Kingdom    3,845    3,989    4,125    4,192
United States    8,616    9,036    9,507    9,892

FIPurpose

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Re: Universal Health Care Practicalities
« Reply #145 on: February 07, 2019, 12:45:32 PM »
Quote
Americans come up with more "for your own good" interference ideas than I can imagine, and they are supposed to be the "land of the free".  Is it the Puritan influence still rearing its head?

Yes, and I for one do not want more, which is what I think Single-Payer health care will invite.

European countries with universal health care don't do this, the UK doesn't do this, Canada, Australia and New Zealand don't do this.  Is the US so different that it will?  So far you are the only American on here saying this, so I wonder if others think this too.

Also, your Medicaid and Medicare don't do this, why would it happen if there were universal health care for all?  You as a country would be saving a huge amount of money with it, based on per capita costs. (shown below)

Total health expenditure per capita in PPP international U.S. dollars (not inflation-adjusted).[1][3][4] https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita


Country    2013    2014    2015    2016
Australia    4,186    4,289    4,493    4,708
Austria    4,861    5,001    5,100    5,227
Belgium    4,505    4,656    4,778    4,840
Canada    4,461    4,502    4,613    4,753
Chile    1,646    1,737    1,877    1,977
Czech Republic    2,380    2,476    2,466    2,544
Denmark    4,772    4,906    5,058    5,205
Estonia    1,652    1,773    1,885    1,989
Finland    3,920    3,935    3,993    4,033
France    4,331    4,464    4,530    4,600
Germany    4,961    5,200    5,353    5,551
Greece    2,175    2,099    2,210    2,223
Hungary    1,776    1,821    1,913    2,101
Iceland    3,707    3,891    4,106    4,376
Ireland    5,033    5,082    5,276    5,528
Israel    2,423    2,595    2,713    2,822
Italy    3,235    3,271    3,352    3,391
Japan    4,207    4,269    4,436    4,519
Korea    2,252    2,396    2,535    2,729
Latvia    1,224    1,311    1,434    1,466
Luxembourg    6,693    6,850    6,818    7,463
Mexico    1,038    1,026    1,054    1,080
Netherlands    5,303    5,322    5,297    5,385
New Zealand    3,402    3,496    3,545    3,590
Norway    5,979    6,136    6,190    6,647
Poland    1,576    1,606    1,704    1,798
Portugal    2,536    2,599    2,664    2,734
Slovak Republic    2,100    2,009    2,059    2,150
Slovenia    2,586    2,647    2,731    2,835
Spain    2,941    3,057    3,180    3,248
Sweden    5,070    5,170    5,266    5,488
Switzerland    6,794    7,096    7,536    7,919
Turkey    978    1,003    997    1,088
United Kingdom    3,845    3,989    4,125    4,192
United States    8,616    9,036    9,507    9,892

https://www.beveragedaily.com/Article/2017/12/20/Sugar-taxes-The-global-picture-in-2017

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Re: Universal Health Care Practicalities
« Reply #146 on: February 07, 2019, 12:55:32 PM »
Quote
Americans come up with more "for your own good" interference ideas than I can imagine, and they are supposed to be the "land of the free".  Is it the Puritan influence still rearing its head?

Yes, and I for one do not want more, which is what I think Single-Payer health care will invite.

European countries with universal health care don't do this, the UK doesn't do this, Canada, Australia and New Zealand don't do this.  Is the US so different that it will?  So far you are the only American on here saying this, so I wonder if others think this too.

Also, your Medicaid and Medicare don't do this, why would it happen if there were universal health care for all?  You as a country would be saving a huge amount of money with it, based on per capita costs.

Probably the most effective strategy among conservatives for avoiding universal health care is pretending that dozens of other developed countries don't already implement it successfully, and at a lesser cost to taxpayers than American pay for their healthcare. This allows them free reign to imagine all sorts of freedom-constraining nightmare scenarios like "OMG what if universal health care kills the skiing industry??"

Chris22

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Re: Universal Health Care Practicalities
« Reply #147 on: February 07, 2019, 12:57:54 PM »
Quote
Americans come up with more "for your own good" interference ideas than I can imagine, and they are supposed to be the "land of the free".  Is it the Puritan influence still rearing its head?

Yes, and I for one do not want more, which is what I think Single-Payer health care will invite.

European countries with universal health care don't do this, the UK doesn't do this, Canada, Australia and New Zealand don't do this.  Is the US so different that it will?  So far you are the only American on here saying this, so I wonder if others think this too.

The last two pages of this thread were people debating how best to tax fat people? 

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Re: Universal Health Care Practicalities
« Reply #148 on: February 07, 2019, 01:00:43 PM »

Orrrr you essentially legislate those industries out of existence.  And then no one skiis.  Supply/Demand tells us that if the price of something increases, demand goes down.  Jack up the price of lift tickets, it's not unthinkable that all of the sudden you've killed enough demand to make skiing unprofitable (at least in the US, rich people could go to Canada or Europe or wherever).

Hmm. Nope. Sounds like you're just talking without actually thinking. When was the last time an industry got taxed out of existence?

Luxury tax on the boat industry in the early 1990s damn near killed it.


Quote
Let's do an estimate on this.

Let's assume a .5% injury rate per year. So out of 200 people that go skiing in a year 1 gets injured.
Each person goes an average of 3 times per year. So something like 1 injury per 600 rides.
The tax is applied to ski lift tickets. Let's make that a nice round $100.
The average cost of an injury is $10k.

600 * 100 / 10000 = 16%

There are a lot of numbers there.  Where do they come from?  The average cost of a broken leg is $10k?  Are you sure?  What about surgery for a torn ACL?  etc etc etc?

Quote
I gave what I think is an upper bound to this idea. No a $7-15 surcharge for lift tickets to cover additional health risks would not "destroy" the ski industry.

Most states charge a 12-18% rental car tax and that industry seems to do just fine. If the ski industry were truly producing that many injuries and creating a large externality on the general populous, then it probably does deserve to go away. But it's not. So your fear seems unfounded to me.


It was an example.  Pick a different one, I don't care. 

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Re: Universal Health Care Practicalities
« Reply #149 on: February 07, 2019, 01:46:37 PM »
I guess I should have expected a non-reply.